Эклампсия. Современный портрет

Abstract

Hypertensive disorders consistently occupy one of the leading causes of maternal mortality. An important role in the diagnosis of eclampsia is given to MRI (magnetic resonance imaging) of the brain, which allows to identify a pathognomonic symptom of eclampsia, posterior reversible encephalopathy syndrome (PRES). Patients and methods. Six clinical cases of patients with eclampsia were retrospectively analyzed. Results. The result of the first screening showed a low risk of pre-eclampsia in 83.3% of patients, and only 16.7% were at risk. All patients developed the eclamptic episode in the third trimester of pregnancy, and they all had elevated diastolic blood pressure (above 110 mm Hg). In 66.7% of patients, systolic blood pressure was within the range of 180–200 mm Hg. There were no disorders of liver function and coagulation system, and platelet levels were within the normal range. According to the brain MRI, all patients were diagnosed with PRES without signs of cerebral circulation disorders. Conclusion. This study demonstrates that the causes and pathogenesis of eclampsia are still unknown. Perhaps we are talking about a new manifestation of the disease, or maybe the causes lie in the pathogenesis, which is not fully understood. Key words: hypertensive disorders of pregnancy, pre-eclampsia, posterior reversible encephalopathy syndrome, eclampsia, PRES