Publication:

Study of MRI lesions in severe preeclampsia and eclampsia in General Government Hospital Guntur, India

Background Study of MRI lesions in patients with PE with severe features and eclampsia and its correlation with clinical findings and laboratory values.

Methods This prospective observational study was conducted in HDU, Department of Obstetrics and Gynecology, GGH Guntur. 50 patients with preeclampsia and eclampsia divided into two groups based on MRI findings:  controls (normal MRI), cases (abnormal MRI). Results analyzed with Chi Square test and student T test.

Results Out of 50 cases, abnormal MRI findings were observed in 24 (48%) cases and 26 (52%) showed normal MRI findings. PRES lesions majority 20 cases (40%), GLIOSIS in 2 (4%) cases, CSVT in 1 (2%) patients, cerebral hemorrhage seen in 1 (2%) patient.  Majority are unbooked cases n= 38 (76%), booked cases n=12 (24%). Symptoms like irritability, headache, unconsciousness, dimness of vision and seizures correlated well with positive MRI findings (P=0.001, P=0.001, P=0.002, P=0.005, P=0.000respectively). Nausea/vomiting and high BP recordings not correlated with positive MRI findings (P=0.21, P=0.312 respectively). Abnormality in blood counts, serum fibrinogen, serum uric acid, PT, APTT and PT INR are not correlated with positive MRI lesions.

Conclusions Symptoms/signs like unconsciousness, irritability, blurring of vision, headache, seizures, GCS <3 and unbooked status of patients of eclampsia and preeclampsia should be a warning for possible development of MRI brain lesions. Whereas nausea, vomiting and high BP recordings are not significantly associated with positive brain lesions in MRI.