Puerperal preeclampsia among women with no history of perinatal preeclampsia

Author(s): Cecilia Lebica, Dalia Somjen*, Luyl Olaf

Objective: To study the characteristics of delayed puerperal preeclampsia/eclampsia in women after delivery and its clinical management. Study design: This multicenter retrospective study involved analysis of cases diagnosed with delayed-onset puerperal preeclampsia/eclampsia upon readmission, from 48 hours-6 weeks after delivery. Total of 170 women were included in the study, out of which 50 were included in case group, and 120 in control group. The identification of cases was made by using the International Classification of Diseases (ICD-9). Data were collected by chart review, and the current version of the SPSS software package was used for data analysis. Results: Case group had mostly non-white racial origin women, 16% of whom were found to be smokers with an elevated maternal pre-pregnancy BMI. There was an increased risk factor for readmission in association with gestational diabetes, and 50% in the case group had a C-section for delivery. Greater birth weight is observed in women with delayed puerperal preeclampsia than those in the control group. Multiple gestations were correlated with a higher risk for readmission. About 34% of patients had a prior history of eclamptic fit at home and were admitted with headaches as a typical symptom observed. Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome was observed in 10% of patients. Intracranial hemorrhage was secondarily responsible for 4% of maternal deaths, and 8 women were admitted to the ICU. Conclusion: Postpartum women should be monitored for early detection of symptoms of preeclampsia. Especially women with this risk factor need appropriate treatment to reduce maternal mortality.