Clinical Correlates of Posterior Reversible Encephalopathy Syndrome in Pregnancy

Abstract

The authors aimed to determine whether clinical findings of preeclampsia predict magnetic resonance imaging ( MRI ) diagnosis of posterior reversible encephalopathy syndrome ( PRES ). The course among preeclamptics/eclamptics with clinically suspected PRES with vs without MRI diagnosis of PRES was compared . Of 46 patients who underwent MRI (eight eclamptics, 38 preeclamptics), five eclamptics (62.5%) and four preeclamptics (10.5%) had confirmed PRES ( P =.004). Patients with PRES were younger (26 years vs 31 years, P =.008) and had a higher prevalence of thrombocytopenia (33% vs 8%, P =.04), a greater prevalence of proteinuria (100% vs 61%, P =.04), and higher peak systolic and diastolic blood pressures ( P <.05). As opposed to findings from previous reports, PRES was not seen uniformly among eclamptic women and was found in 10.5% of preeclamptics with clinical suspicion of PRES in this study. Given that no single or set of findings were reliable predictors of PRES , consideration for rigorous management of hypertension should be applied to all patients with preeclampsia and eclampsia.