Incidence and Clinical Manifestations of Posterior Reversible Encephalopathy Syndrome (PRES) in Patients with Eclampsia. 2017-2021 Data from a High Specialty Medical Unit, Mexico City

Abstract

Aims: To identify the incidence of posterior reversible encephalopathy syndrome (PRES) on Tomography scan of the skull (CT) and/or Magnetic Resonance Imaging (MRI) and its clinical manifestations in patients with eclampsia. Study Design: Observational, cross-sectional, retrospective and descriptive study. Place and Duration of Study: Patients with eclampsia admitted to the Intensive Care Unit (ICU) of a High Specialty Medical Unit (Hospital de Gineco-Obstetricia No. 3. Centro Médico Nacional “La Raza”. Instituto Mexicano del Seguro Social) in Mexico City between 2017 to 2021. Methodology: We studied a series of 25 cases with eclampsia admitted to the ICU. Their files were consulted to know the incidence of PRES on CT, MRI or both, as well as the signs and symptoms that accompanied the eclampsia. The data was analyzed with descriptive statistics using the statistical package SPSS version 20. Results: Age 26.2±7.13 years, parity (median) 1, gestational age 34.4±5.05 weeks, comorbidities 12%, prepartum eclampsia 72% (n=18), intrapartum 4% (n=1) and postpartum 24% (n= 6). Imaging studies were performed only in 68% (n=17), the most used was CT (n=16). They found normal findings in 52.94%, PRES 29.41% (n=5), generalized edema 5.88%, Fisher class IV subarachnoid hemorrhage 5.88%, and parenchymal hemorrhage communicated to the IV ventricle 5.88%. The most frequent symptom was headache 40% and the most frequent sign was hyperreflexia 48%. Conclusion: The incidence of PRES was 29.41%. CT was performed most frequently. The most frequent symptom was headache and the most frequent sign was hyperreflexia.