A 27-year-old woman presents on the fifth day after an uncomplicated vaginal delivery with a generalized tonic-clonic seizure. She had normal blood pressures throughout pregnancy and no proteinuria at any visit. Her BP now is 164/108 mmHg. What is the most likely diagnosis?
- A Late postpartum eclampsia ✓
- B Epilepsy
- C Cerebral venous sinus thrombosis
- D Intracranial hemorrhage
Correct answer: A. Late postpartum eclampsia
Explanation
Postpartum eclampsia can occur up to 6 weeks after delivery even when antepartum and intrapartum blood pressures were entirely normal, and this entity is called late postpartum eclampsia. Hypertension and seizures on day 5 fit this diagnosis, and magnesium sulfate remains the treatment. Seizures plus marked hypertension also occur with cerebral venous thrombosis and hemorrhage, but those are diagnoses of exclusion here, and epilepsy would not typically present with this degree of hypertension.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.