The Critical Role of CT Imaging in Detecting Acute Neurological Complications of Eclampsia: A Case Series

Ayu Angelina Ronosulistyo, Zulvayanti Zulvayanti, Dini Hidayat, Windi Nurdiawan, Hadi Susiarno, Dini Pusianawati, Vyanda Sri Weningtyas


Abstract


Abstract

Introduction: An intracranial hemorrhage (ICH) is a rare condition but potentially life-threatening event, especially in pregnancy, and could happen in patients with eclampsia. At Hasan Sadikin General Hospital (RSHS), several eclampsia cases are admitted annually, some with worsening neurological conditions. Neuroimaging using CT-Scan is indicated in patients with seizures, decreased consciousness, or visual disturbances to detect intracranial pathology.  

Case: We reported three cases of maternal eclampsia, two patients' chief complaint was seizures, but all of our patients were unconscious. All of our patients had a previous history of pre-eclampsia in the last pregnancy. All of our patients performed a CT scan performed in postpartum patients as a neurologic examination. All of our patients have worse outcomes. The Medical and Health Research Ethics Committee of the Faculty of Medicine, Padjajaran University with Ref no: DP.04.03/D/XIV.6.5/71/2025.

Conclusion: Neuroimaging in patients with seizure-induced worsening of the condition has an important role in identifying other abnormalities, specifically intracranial hemorrhage. In this study, we conclude that patients with seizures in pregnancy should be screened with neuroimaging (computed tomography scan) to rule out central nervous system pathology, thereby improving the patient's condition and reducing maternal mortality.

Keywords: CT scan, Convulsion, Eclampsia, Pregnancy

 

Peran Kritis Pencitraan CT dalam Mendeteksi Komplikasi Neurologis Akut pada Eklampsia: Seri Kasus

Abstrak

Pendahuluan: Perdarahan intrakranial (PIK) merupakan kondisi langka namun berpotensi mengancam jiwa, terutama pada kehamilan, dan dapat terjadi pada pasien eklampsia. Neuroimaging menggunakan CT-Scan berperan dalam deteksi dini perburukan kondisi pasien dengan penurunan kesadaran.

Kasus: Penelitian ini melaporkan tiga kasus eklampsia maternal, keluhan utama dua pasien adalah kejang, namun semua pasien pada penelitian ini tidak sadar. Semua pasien memiliki riwayat preeklampsia sebelumnya pada kehamilan terakhir. Semua pasien melakukan CT scan sebagai pemeriksaan neurologis. Semua pasien memiliki hasil yang lebih buruk. Komite Etik Penelitian Kedokteran dan Kesehatan Fakultas Kedokteran Universitas Padjadjaran dengan Ref no: DP.04.03/D/XIV.6.5/71/2025.

Kesimpulan: Neuroimaging pada pasien dengan kondisi yang memburuk akibat kejang memiliki peran penting dalam mengidentifikasi kelainan lain, khususnya perdarahan intrakranial. Dalam penelitian ini, peneliti menyimpulkan bahwa pasien dengan kejang selama kehamilan harus diskrining dengan neuroimaging (pemindaian tomografi terkomputasi) untuk menyingkirkan patologi sistem saraf pusat sehingga memperbaiki kondisi pasien dan mengurangi angka kematian ibu.

Kata kunci: CT scan, Eklampsia, Kehamilan, Kejang


Keywords


CT scan, Convulsion, Eclampsia, Pregnancy

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References


Fairhall JM, Stoodley MA. Intracranial hemorrhage in pregnancy. Obstet Med. 2009 Dec [cited 2023 Aug 22];2(4):142. Available from: /PMC/articles/PMC4989666/

Jaigobin C, Silver FL. Stroke and pregnancy. Stroke. 2000 [cited 2023 Aug 22];31(12):2948–51. Available from: https://pubmed.ncbi.nlm.nih.gov/11108754/

Bushnell C, Chireau M. Preeclampsia and Stroke: Risks during and after Pregnancy. Stroke Res Treat. 2011 [cited 2023 Aug 22];2011. Available from: /PMC/articles/PMC3034989/

James AH, Bushnell CD, Jamison MG, Myers ER. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstetrics and gynecology. 2005 [cited 2023 Aug 22];106(3):509–16. Available from: https://pubmed.ncbi.nlm.nih.gov/16135580/

Lanska DJ, Kryscio RJ. Stroke and intracranial venous thrombosis during pregnancy and puerperium. Neurology. 1998 [cited 2023 Aug 22];51(6):1622–8. Available from: https://pubmed.ncbi.nlm.nih.gov/9855513/

Phipps EA, Thadhani R, Benzing T, Karumanchi SA. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019 May 1 [cited 2023 Aug 22];15(5):275. Available from: /PMC/articles/PMC6472952/

Pradana CM., Parti DD., Sakinah EN. 2023. Covid-19 Infection and the Preeclampsia in Pregnant Women. INAJOG Vol 11(4): 235-240

Rebahi H, Still ME, Faouzi Y, El Adib AR. Risk factors for eclampsia in pregnant women with preeclampsia and positive neurosensory signs. Turk J Obstet Gynecol. 2018 [cited 2023 Aug 22];15(4):227. Available from: /PMC/articles/PMC6334241/

Ramesh K, Gandhi S, Rao V. Socio-Demographic and Other Risk Factors of Pre Eclampsia at a Tertiary Care Hospital, Karnataka: Case-Control Study. J Clin Diagn Res. 2014 [cited 2023 Aug 22];8(9):JC01. Available from: /PMC/articles/PMC4225915/

Fox R, Kitt J, Leeson P, Aye CYL, Lewandowski AJ. Preeclampsia: Risk Factors, Diagnosis, Management, and the Cardiovascular Impact on the Offspring. J Clin Med. 2019 Oct 1 [cited 2023 Aug 22];8(10). Available from: /PMC/articles/PMC6832549/

Khandaker S, Haldar M, Munshi S. Intra Cerebral Changes Detected by CT Scan of Brain in Eclampsia. Vol. 1, Austin J Obstet Gynecol. 2014. Available from: www.austinpublishinggroup.com

Grear KE, Bushnell CD. Stroke and Pregnancy: Clinical Presentation, Evaluation, Treatment and Epidemiology. Clin Obstet Gynecol. 2013 Jun [cited 2023 Aug 22];56(2):350. Available from: /PMC/articles/PMC3671374/

Akre S, Sharma K, Chakole S, Wanjari MB. Eclampsia and Its Treatment Modalities: A Review Article. Cureus. 2022 Sep 12 [cited 2023 Aug 22];14(9). Available from: /PMC/articles/PMC9555679/

Barno A, Freeman DW. Maternal deaths due to spontaneous subarachnoid hemorrhage. Am J Obstet Gynecol. 1976 Jun 1 [cited 2023 Aug 23];125(3):384–92. Available from: https://pubmed.ncbi.nlm.nih.gov/1275028/

Cipolla MJ. Cerebrovascular function in pregnancy and eclampsia. Hypertension. 2007 Jul [cited 2023 Aug 23];50(1):14–24. Available from: https://pubmed.ncbi.nlm.nih.gov/17548723/

Ganzevoort W, Rep A, Bonsel GJ, De Vries JIP, Wolf H. Plasma volume and blood pressure regulation in hypertensive pregnancy. J Hypertens. 2004 [cited 2023 Aug 23];22(7):1235–42. Available from: https://pubmed.ncbi.nlm.nih.gov/15201535/

Roeshadi RH. 2007. Upaya Menurunkan Angka Kesakitan dan Angka Kematian Ibu pada Penderita Preeklampsia dan Eklampsia. INAJOG Vol 31(3): 123-133

Gurjar B, Rawat RP. CT scan findings in patients of eclampsia. Int J Reprod Contracept Obstet Gynecol. 2017 Jul 26;6(8):3405.

Vijayasree M, Murali G V. Convulsions in pregnancy Health Renaissance. Vol. 13. 2015

Eclampsia. [cited 2023 Aug 23]. Available from: https://www1.cgmh.org.tw/intr/intr5/c6700/OBGYN/f/web/Eclampsia/index.htm




DOI: http://dx.doi.org/10.24198/obgynia.v8i3.924

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