A 32-year-old woman delivered vaginally at 38 weeks. On postpartum day 3, she develops a generalized tonic-clonic seizure. Her blood pressure recorded at discharge was 138/88 mmHg, and prenatal blood pressures were normal throughout. Urine protein was trace at delivery. Which of the following is the most appropriate diagnosis?

• A Late postpartum eclampsia ✓
• B Cerebral venous thrombosis
• C Idiopathic epilepsy
• D Hypertensive encephalopathy

Explanation

Postpartum eclampsia can occur up to 4 weeks after delivery, most commonly within 48 hours but sometimes later. The term 'late postpartum eclampsia' applies when seizures occur beyond 48 hours postpartum. B history of normal prenatal BP and trace protein does not exclude it. Cerebral venous thrombosis typically presents with headache and focal deficits, not isolated seizures. Hypertensive encephalopathy requires sustained severe hypertension, which is absent here.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.