MRI Brain Lesions in Eclampsia: A Series of 50 Cases Admitted to HDU of a Tertiary Care Hospital

  • Krishna Dahiya Department of Obstetrics and Gynecology, PGIMS, Rohtak, India
  • Seema Rohilla Department of Radiodiagnosis, PGIMS, Rohtak, India
  • Kriti Agarwal Department of Obstetrics and Gynecology, PGIMS, Rohtak, India
  • Mahesh Rathod Department of Obstetrics and Gynecology, PGIMS, Rohtak, India
  • Archit Dahiya Department of Medicine, PGIMS, Rohtak, India
Keywords: Eclampsia, MRI, Neurological


Objective: To correlate the Magnetic Resonance Imaging findings and clinical presentation in patients of eclampsia.Materials and methods: This one year prospective study was conducted in the HDU of Department of Obstetrics and Gynecology, PT.B.D.Sharma, PGIMS, Rohtak .A total of 50 women with eclampsia (both antepartum and postpartum) were divided into two groups: a) study group patients with abnormal MRI b) control group: b) control group: patients with normal MRI.Comparison was done using chi-square test and unpaired student ‘t’ test.Results: MRI revealed abnormal findings in 24% of women, commonest diagnosis being CVT without infarct (10%) followed by infarct (8%), PRES (4%) and HLE (2%).Totally 66% (n = 33) of the women presented with postpartum eclampsia while 34% (n = 17) had antepartum eclampsia.96%(n = 48) were unbooked cases. Unconsciousness, altered sensorium, headache, blurring of vision, seizures, GCS < 3 correlated well with MRI findings (p = 0.000, p = 0.027, p = 0.001, p = 0.007, p = 0.005, p = 0.000 respectively) whereas fundoscopic changes did not (p = 0.520). The mean uric acid and serum creatinine levels was higher (0.41 ± 0.11 mmol/ L vs 0.26 ± 0.10 mmol/ L and 80 ± 18 µmol/ L vs 71 ± 9 µmol/ L) in the study group and this was statistically significant (p = 0.003, p = 0.04 respectively).There was no statistically significant difference between blood pressure values of cases with or without MR imaging evidence of brain lesions. There was no maternal mortality among 50 cases. The sensitivity, specificity, positive predictive value and negative predictive value of neurological findings for abnormal MRI in patients with eclampsia was found to be 91.7%, 73.7%, 52.4%, 96.6% respectively.Conclusion: Unconsciousness, altered sensorium, headache, blurring of vision,seizures, GCS < 3, elevated uric acid and serum creatinine levels in the follow-up of pregnant patients with preeclampsia/eclampsia should be a warning for possible brain lesions whereas booking status, mean BP, fundoscopy, platelet, hemoglobin, liver enzymes were not significantly associated with positive MRI findings in patients of eclampsia.

Author Biography

Kriti Agarwal, Department of Obstetrics and Gynecology, PGIMS, Rohtak, India
senior residentdepartment of obstetrics and Gynecology


Mishra R. Ian Donald’s practical obstetric problems. 6thed, New Delhi; Advert Arnold B I Publication; 2007.

SibaiBM. Diagnosis, prevention and management of eclampsia. ObstetGynecol2005; 105: 402–10.

Treadwell SD, Thanvi B, Robinson TG. Stroke in pregnancy and the puerperium. Postgrad Med J 2008; 84: 238–45.

Jaigobin C, Silver FL. Stroke and pregnancy. Stroke 2000; 31:2948–51.

Harandou M, Madani N, Labibe S, Messouak O, Boujraf S, Benkirane S. Neuroimaging findings in eclamptic patients still symptomatic after 24 hours: A descriptive study about 19 cases. Ann Fr Anesth Reanim. 2006; 25: 577–83.

6.Schwartz RB, Feske SK, Polak JF,DeGirolami U, Iaia A, Beckner KM et al.Preeclampsia-eclampsia: clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy. Radiology 2000; 217:371-6.

Keswani SC, Wityk R. Don't throw in the towel! A case of reversible coma. J NeurolNeurosurg Psychiatry 2002; 73:83-4.

Covarrubias DJ, Luetmer PH, Campeau NG. Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion weighted MR images. AJNR Am J Neuroradiol 2002; 23:1038-48.

Demirtaş O, Gelal F, Vidinli BD, Demirtaş LO , Uluç E, Baloğlu A. Cranial MR imaging with clinical correlation in preeclampsia and eclampsia. DiagnInterv Radiol 2005; 11:189-94.

Jindal MA, Gaikwad HS, Hasija BD, Vani K. Comparison of neuroimaging by CT and MRI and correlation with neurological presentation in eclampsia. International Journal of Reproduction,Contraception, Obstetrics and Gynecology2013; 2:83-7.

Kokila MS, Dwivedi AD. Correlation of Clinical and Neuroimaging Findings affecting Management in Postpartum Eclampsia: A Prospective Study. Journal of South Asian Federation of Obstetrics and Gynaecology 2011; 3:125-30.

Majoko F, Mujaji C. Maternal outcome in eclampsia at Harare Maternity Hospital. Cent Afr J Med 2001; 47:123-8.

Chakravarty A, Chakrabarti SD. The neurology of eclampsia: some observations. Neurol India 2002; 50:128-35.

Begum F, Nahar K, Ahmed MU, Ferdousi RA, Akter FA, Rahman MM. Study on Neurological Manifestations of Eclampsia & Findings of CT scan of Brain. Mymensingh Med J. 2015; 24:691-6.

Chang WN, Lui CC, Chang JM.CTand MRI findings of eclampsia and their correlation with neurologic symptoms. Zhonghua Yi XueZa Zhi.1996; 57:191-7.

McCarthy AL, Woolfson RG, Raju SK, Poston L. Abnormal endothelial cell function of resistance arteries from women with preeclampsia. Am J ObstetGynecol 1993; 168:1323-30.

Brouh Y, Jean KK, Ouattara A, Tétchi Y, Pete Y, Koffi N .Brain lesions in eclampsia: A series of 39 cases admitted in an Intensive Care Unit. Indian J Crit Care Med 2016; 20:178–81.

How to Cite
Dahiya K, Rohilla S, Agarwal K, Rathod M, Dahiya A. MRI Brain Lesions in Eclampsia: A Series of 50 Cases Admitted to HDU of a Tertiary Care Hospital. jfrh. 12(1):51-6.
Original Articles