Posterior reversible encephalopathy syndrome (PRES) on the second postpartum day: learning experience from a case report and literature review
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Title
Posterior reversible encephalopathy syndrome (PRES) on the second postpartum day: learning experience from a case report and literature review
Subject
HELLP syndrome, Maternal mortality, MRI, Neurology, Preeclampsia, PRES
Description
Abstract
Background Posterior reversible encephalopathy syndrome (PRES) is an uncommon neurological disorder which is
characterised by variable symptoms. The transient clinical condition may be underestimated and misdiagnosed as
other conditions, especially, among pregnant women with severe preeclampsia, eclampsia, and HELLP (hemolysis,
elevated liver enzymes, and low platelets) syndrome in the puerperium. We hereby contribute to the literature this
rare complication and hightlight the appropriate management of PRES .
Presentation case A pregnant woman (gravida 3, parity 2) had a normal antenatal course. However, she was
diagnosed with severe preeclampsia and HELLP syndrome at 29 weeks and 5 days of gestation. Therefore, she
was indicated for a medical termination of pregnancy following a patient’s consent at our tertiary referral hospital.
Severely, the patient developed rapidly with altered mental health in early puerperium. In result, PRES was diagnosed
based on a brain magnetic resonance imaging (MRI) evidence with typical findings. After a strict multidisciplinary
management, the clinical condition improved after 5 days of onset and recovered completely after a 4-month
follow-up without any sequelae.
Conclusion In summary, despite its rarity, clinicians ought to be knowledgeable and raise an aware of PRES during
pregnancy. Importantly, a brain imaging modalities should be taken into account among pregnant women with
neurological symptoms subsequent to severe preeclampsia. In addition to early diagnosis, a timely appropriate
treatment with multidisciplinary team is strongly indicated. Further studies with a large case series are required for this
uncommon entity.
Keywords HELLP syndrome, Maternal mortality, MRI, Neurology, Preeclampsia, PRES
Background Posterior reversible encephalopathy syndrome (PRES) is an uncommon neurological disorder which is
characterised by variable symptoms. The transient clinical condition may be underestimated and misdiagnosed as
other conditions, especially, among pregnant women with severe preeclampsia, eclampsia, and HELLP (hemolysis,
elevated liver enzymes, and low platelets) syndrome in the puerperium. We hereby contribute to the literature this
rare complication and hightlight the appropriate management of PRES .
Presentation case A pregnant woman (gravida 3, parity 2) had a normal antenatal course. However, she was
diagnosed with severe preeclampsia and HELLP syndrome at 29 weeks and 5 days of gestation. Therefore, she
was indicated for a medical termination of pregnancy following a patient’s consent at our tertiary referral hospital.
Severely, the patient developed rapidly with altered mental health in early puerperium. In result, PRES was diagnosed
based on a brain magnetic resonance imaging (MRI) evidence with typical findings. After a strict multidisciplinary
management, the clinical condition improved after 5 days of onset and recovered completely after a 4-month
follow-up without any sequelae.
Conclusion In summary, despite its rarity, clinicians ought to be knowledgeable and raise an aware of PRES during
pregnancy. Importantly, a brain imaging modalities should be taken into account among pregnant women with
neurological symptoms subsequent to severe preeclampsia. In addition to early diagnosis, a timely appropriate
treatment with multidisciplinary team is strongly indicated. Further studies with a large case series are required for this
uncommon entity.
Keywords HELLP syndrome, Maternal mortality, MRI, Neurology, Preeclampsia, PRES
Creator
Anh Dinh Bao Vuong1† , Xuan Trang Thi Pham1 and Phuc Nhon Nguyen1,2*†
Source
https://doi.org/10.1186/s12245-024-00707-0
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Anh Dinh Bao Vuong1† , Xuan Trang Thi Pham1 and Phuc Nhon Nguyen1,2*†, “Posterior reversible encephalopathy syndrome (PRES) on the second postpartum day: learning experience from a case report and literature review,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12435.