Eclampsia following cesarean section with HELLP syndrome and multiple organ failure.
We present a rare case of postpartum eclampsia with overt acute heart and renal failure, in the absence of any precursive signs of preeclampsia. A 41-year-old parturient underwent elective cesarean section for the delivery of twins under spinal anesthesia. Prior to the procedure, preoperative laboratory examination revealed only traceable proteinuria but she had hypertension perioperatively. Approximately 8 hours after the cesarean section, she developed seizures, followed by evident acute heart and renal failure. The diagnosis of postpartum eclampsia with HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome was established and she was admitted to the surgical intensive care unit for close care. Fortunately, the patient recovered fully and was discharged 26 days later. From this illustrative example, unexplainable and sustained hypertension following cesarean section should serve as a signal to warn the health care staff concerned about the possibility of impending life-threatening postpartum eclampsia.
Chan
Shun-Ming
SM
Department of Anesthesiology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, 325 Section 2 Cheng-Gong Road, Taipei, Taiwan, R.O.C.
Lu
Chih-Cherng
CC
Ho
Shung-Tai
ST
Liaw
Wen-Jinn
WJ
Cherng
Chen-Hwan
CH
Chen
Wei-Hwa
WH
Lin
Tso-Chou
TC
D000328:Adult; D004461:Eclampsia / Q000175:diagnosis*; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis*; D006801:Humans; D009102:Multiple Organ Failure / Q000209:etiology*; D011247:Pregnancy