Eclampsia-Induced Posterior Reversible Encephalopathy Syndrome in a Donor Oocyte Recipient
Abstract
Objective: Posterior reversible encephalopathy syndrome (PRES) has been robustly associated with preeclampsia, hyperperfusion or endothelial dysfunction suggested as possible mechanisms. In this article, we report an illustrative case of this complication in a patient with risk factors for hypertensive disorders in pregnancy, including advanced maternal age and donor oocyte fertilization.
Case report: We present a case of a 40-year-old pregnant, donor oocyte recipient with sudden decreased visual acuity accompanied by hypertension, proteinuria and tonic-clonic seizures. Magnetic resonance imaging (MRI) of the brain showed bilateral lesions in the parieto-occipital regions suggestive of vasogenic edema, leading us to suspect posterior reversible encephalopathy syndrome. The patient underwent an emergency cesarean section and labetalol and magnesium sulfate were administered intravenously. The neurological symptoms and radiological findings resolved following delivery and the patient’s blood pressure normalized, supporting the diagnosis of posterior reversible encephalopathy syndrome.
Conclusion: Pregnancy by donor oocyte fertilization may entail a higher risk of eclampsia and associated posterior reversible encephalopathy syndrome.
Morton A, Higgins S, Mullins B. HELLP, eclampsia and posterior reversible encephalopathy in a young woman with streak ovary syndrome. Aust New Zeal J Obstet Gynaecol 2005; 45: 173–4.
Schutte JM, Schuitemaker NW, Steegers EA, Van Roosmalen J. Maternal death after oocyte donation at high maternal age: Case report. Reprod Health 2008; 5: 1-4.
Fukami T, Asakura H, Takeshita T. Reversible posterior leukoencephalopathy syndrome due to eclampsia in a woman with a twin pregnancy produced with donated oocytes. J Nippon Med Sch 2013; 80: 230–3.
Savasi VM, Mandia L, Laoreti A, Cetin I. Maternal and fetal outcomes in oocyte donation pregnancies. Hum Reprod Update 2016; 22: 620–33.
Storgaard M, Loft A, Bergh C, So V, Aittomaki K, Oldereid N, et al. Obstetric and neonatal complications in pregnancies conceived after oocyte donation : a systematic review and meta-analysis. BJOG 2017; 561–72.
Masoudian P, Nasr A, Nanassy J, Demellawy D El. Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension : a systematic review and metaanalysis. Am J Obstet Gynecol 2020; 214: 328–39.
Fischer M, Schmutzhard E. Posterior reversible encephalopathy syndrome. J Neurol 2017; 264: 1608–16.
Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: Clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol 2015; 14: 914–25.
Rana S, Lemoine E, Granger J, Karumanchi SA. Preeclampsia: Pathophysiology, Challenges, and Perspectives. Circ Res 2019; 124: 1094–112.
Kawwass JF, Monsour M, Crawford S, Kissin DM, Session DR, Kulkarni AD, et al. Trends and outcomes for donor oocyte cycles in the United States,
-2010. J Am Med Assoc 2013; 310: 2426–34.
Wyns C, Bergh C, Geyter C, Kupka MS, Motrenko T, Rugescu I, et al. ART in Europe, 2016: results generated from European registries by ESHRE. Hum Reprod Open 2020; 2020: hoaa032.
Pecks U, Maass N, Neulen J. Eizellspende - Ein risikofaktor für schwangerschaftshochdruck metaanalyse und fallserie. Dtsch Arztebl 2011;108: 23–31.
Postma IR, Slager S, Kremer HPH, Cees De Groot J, Zeeman GG. Long-term Consequences of the Posterior reversible encephalopathy syndrome in Eclampsia and Preeclampsia: A Review of the Obstetric and Nonobstetric Literature. Obstet Gynecol Surv 2014; 69: 287-300.
Legriel S, Schraub O, Azoulay E, Hantson P, Magalhaes E, Coquet I, et al. Determinants of Recovery from severe Posterior reversible encephalopathy syndrome. PLoS One 2012; 7: e44534.
Levron Y, Dviri M, Segol I, Yerushalmi GM, Hourvitz A, Orvieto R, et al. The “immunologic theory” of preeclampsia revisited: A lesson from donor oocyte gestations. Am J Obstet Gynecol 2014; 211: 383.e1-5.
Redman CWG, Sargent IL. Immunology of Pre-Eclampsia. Am J Reprod Immunol 2010; 63: 534–43.
Lashley LE, Hoorn MP, Haasnoot GW, Roelen DL, Claas FHJ. Uncomplicated oocyte donation pregnancies are associated with a higher incidence of human leukocyte antigen alloantibodies. Hum Immunol 2014; 75: 555–60.
van der Hoorn MLP, Lashley EELO, Bianchi DW, Claas FHJ, Schonkeren CMC, Scherjon SA. Clinical and immunologic aspects of egg donation pregnancies: A systematic review. Hum Reprod Update 2010; 16: 704–12.
Files | ||
Issue | Vol 14, No 4 (December 2020) | |
Section | Case Reports | |
DOI | https://doi.org/10.18502/jfrh.v14i4.5211 | |
Keywords | ||
Oocyte Donation Posterior Reversible Encephalopathy Syndrome Eclampsia |
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