A woman delivered vaginally 10 days ago and now presents with headache, BP 168/112 mmHg, and a generalised tonic-clonic seizure. Which statement best describes this presentation?
- A This cannot be eclampsia because seizures occurred beyond 48 hours postpartum
- B Most likely an idiopathic epilepsy unmasked by delivery
- C Late postpartum eclampsia, recognized up to 12 weeks after delivery ✓
- D Cerebral venous sinus thrombosis, and magnesium sulfate is contraindicated
Correct answer: C. Late postpartum eclampsia, recognized up to 12 weeks after delivery
Explanation
Although most cases of postpartum eclampsia occur within 48 hours of delivery, late postpartum eclampsia is well described and ACOG recognizes postpartum pre-eclampsia and eclampsia presenting up to 12 weeks after delivery. Magnesium sulfate remains the anticonvulsant of choice in this setting, so option D is wrong despite venous sinus thrombosis being a differential for postpartum seizure with headache. New-onset hypertension with convulsion in the postpartum period should be treated as eclampsia first.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.