Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.06.008
Brazilian Journal of Anesthesiology
Case Report

Eclampsia and posterior reversible encephalopathy syndrome in a parturient complicated by SARS COVID-19 pneumonia

Eclâmpsia e síndrome de encefalopatia posterior reversível em uma parturiente complicada por pneumonia por SARS COVID-19

Vijay Shankar; Purnima Dhar; Jai George; Anil Sharma; Anupam Raj

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Abstract

A primigravida at 32 weeks of gestation presented to us with eclampsia and Posterior Reversible Encephalopathy Syndrome (PRES) along with SARS COVID-19 pneumonia. Immediate termination of pregnancy was done under general anesthesia and patient was electively ventilated in view of increased oxygen requirements. Further therapy using magnesium sulphate, antihypertensives, steroids, and convalescent plasma was carried out. The condition of the patient steadily improved leading to her extubation on the 4th postoperative day and subsequent discharge on the 8th day of admission.

Abbreviations
ACE 2Angiotensin converting enzyme 2COVID-19Coronavirus disease 2019LDHLactate DehydrogenaseMRIMagnetic Resonance ImagingPCRPolymerase Chain reactionPRESPosterior Reversible Encephalopathy SyndromeRTReverse TranscriptaseSIMV + PSSynchronized Intermittent Mandatory Ventilation + Pressure Support

Keywords

COVID-19;  Posterior reversible encephalopathy syndrome;  Eclampsia

Resumo

Uma primigesta com 32 semanas de gestação nos apresentou eclâmpsia e síndrome de encefalopatia posterior reversível (PRES), juntamente com pneumonia por SARS COVID-19. A interrupção imediata da gravidez foi feita sob anestesia geral e a paciente foi ventilada eletivamente devido ao aumento das necessidades de oxigênio. Foi realizada terapia adicional com sulfato de magnésio, anti-hipertensivos, esteroides e plasma convalescente. O estado da paciente melhorou continuamente, levando à extubação no 4º dia de pós-operatório e alta subsequente no 8º dia de internação.

Palavras-chave

COVID-19; Síndrome de encefalopatia posterior reversível; Eclâmpsia

References

1 J. Allotey, E. Stallings, M. Bonet, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis BMJ, 370 (2020), p. m3320

2 A. Trikha, A. Sharma, R. Kumar Posterior reversible encephalopathy syndrome J Obstet Anaesth Crit Care, 4 (2014), pp. 59-63

3 J. Rogg, A. Baker, G. Tung Posterior reversible encephalopathy syndrome (PRES): another imaging manifestation of COVID-19 Interdiscip Neurosurg, 22 (2020), Article 100808

4 L. Llansó, X. Urra Posterior reversible encephalopathy syndrome in COVID-19 disease: a case-report SN Compr Clin Med (2020), pp. 1-3, 10.1007/s42399-020-00470-2 Online ahead of print

5 F. Noro, F. de Mendonça Cardoso, E. Marchiori COVID-19 and posterior reversible encephalopathy syndrome Neurol Clin Pract, 11 (2021), pp. e202-e204
 

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