Correlation between neuroimaging (CT scan) and neurological presentation in antepartum and postpartum eclampsia

摘要

Background: Eclampsia is a pregnancy related condition with high mortality and morbidity along with perinatal mortality and morbidity. The following study is designed to correlate the neurological presentation with neuroimaging (CT scan brain) in antepartum and postpartum eclampsia patients, which will guide in proper management of the patients. Methods: A prospective study conducted over a period of one year. 100 patients were included in all. The neurological presentation and neuroimaging findings were correlated in all antepartum and postpartum eclampsia patients who met the study criteria. The comparison was done using chi-square test and unpaired student 't' test. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to find the accuracy of neurological presentation in determining the diagnosis and kappa agreement. Results: Out of the 100 patients studied, 52 had significant CT scan findings. Of these 52, 35 women had neurological signs and symptoms, and 17 cases did not have neurological signs and symptoms (p=0.003). The sensitivity, specificity, positive predictive value and negative predictive value were found to be 67.31%, 62.5%, 66.04% and 63.83% respectively and the diagnostic accuracy was found to be 65%. Conclusions: Evaluation of neurological signs and symptoms in women with eclampsia is an important assessment which helps for the further management. Neuroimaging has limited role in uncomplicated cases. Neuroimaging is indicated in atypical presentation, fatal cases and those resistant to standard anti-eclamptic therapy, where the signs and symptoms fail to predict the likelihood diagnosis.