Eclampsia with RCVS: Postpartum seizure provoked by methergine

Gregory W. Kirschen; Katerina Hoyt; Emily Johnson; Silka Patel

doi:10.1016/j.preghy.2022.01.002

Eclampsia with RCVS: Postpartum seizure provoked by methergine

Gregory W. Kirschen, Katerina Hoyt, Emily Johnson, Silka Patel

School of Medicine

Research output: Contribution to journal › Letter › peer-review

Abstract

Background: Eclampsia is a pregnancy complication characterized by generalized tonic-clonic convulsions. Not all seizures in pregnancy are eclamptic, and other causes include epilepsy, infection, stroke, tumor, and ruptured aneurysm. Case: A 19-year-old G1P0 presented in labor at term. She had a generalized tonic-clonic seizure one hour after vaginal delivery for which she received methergine for uterine atony. Seizure activity resolved with lorazepam and magnesium sulfate for presumed eclampsia. Brain imaging revealed vasoconstriction of the left posterior cerebral artery and blood in the subarachnoid space, and she was diagnosed with eclampsia with reversible cerebral vasoconstrictive syndrome (RCVS). Conclusion: RCVS is a pregnancy-related cause of seizure that should remain on the differential for any patient presenting with a seizure in the peripartum period, especially with use of vasoconstrictive agents. Management is controversial but involves calcium channel blockers and magnesium sulfate, as well as avoidance of vasoconstrictive agents.

Original language	English (US)
Pages (from-to)	131-133
Number of pages	3
Journal	Pregnancy Hypertension
Volume	27
DOIs	https://doi.org/10.1016/j.preghy.2022.01.002
State	Published - Mar 2022

Keywords

Blood pressure
Hypertension
Methergine
Pregnancy
Vasoconstriction

ASJC Scopus subject areas

Obstetrics and Gynecology
Internal Medicine

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10.1016/j.preghy.2022.01.002

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title = "Eclampsia with RCVS: Postpartum seizure provoked by methergine",

abstract = "Background: Eclampsia is a pregnancy complication characterized by generalized tonic-clonic convulsions. Not all seizures in pregnancy are eclamptic, and other causes include epilepsy, infection, stroke, tumor, and ruptured aneurysm. Case: A 19-year-old G1P0 presented in labor at term. She had a generalized tonic-clonic seizure one hour after vaginal delivery for which she received methergine for uterine atony. Seizure activity resolved with lorazepam and magnesium sulfate for presumed eclampsia. Brain imaging revealed vasoconstriction of the left posterior cerebral artery and blood in the subarachnoid space, and she was diagnosed with eclampsia with reversible cerebral vasoconstrictive syndrome (RCVS). Conclusion: RCVS is a pregnancy-related cause of seizure that should remain on the differential for any patient presenting with a seizure in the peripartum period, especially with use of vasoconstrictive agents. Management is controversial but involves calcium channel blockers and magnesium sulfate, as well as avoidance of vasoconstrictive agents.",

keywords = "Blood pressure, Hypertension, Methergine, Pregnancy, Vasoconstriction",

author = "Kirschen, {Gregory W.} and Katerina Hoyt and Emily Johnson and Silka Patel",

note = "Publisher Copyright: {\textcopyright} 2022 International Society for the Study of Hypertension in Pregnancy",

year = "2022",

month = mar,

doi = "10.1016/j.preghy.2022.01.002",

language = "English (US)",

volume = "27",

pages = "131--133",

journal = "Pregnancy Hypertension",

issn = "2210-7789",

publisher = "Elsevier BV",

}

TY - JOUR

T1 - Eclampsia with RCVS

T2 - Postpartum seizure provoked by methergine

AU - Kirschen, Gregory W.

AU - Hoyt, Katerina

AU - Johnson, Emily

AU - Patel, Silka

PY - 2022/3

Y1 - 2022/3

N2 - Background: Eclampsia is a pregnancy complication characterized by generalized tonic-clonic convulsions. Not all seizures in pregnancy are eclamptic, and other causes include epilepsy, infection, stroke, tumor, and ruptured aneurysm. Case: A 19-year-old G1P0 presented in labor at term. She had a generalized tonic-clonic seizure one hour after vaginal delivery for which she received methergine for uterine atony. Seizure activity resolved with lorazepam and magnesium sulfate for presumed eclampsia. Brain imaging revealed vasoconstriction of the left posterior cerebral artery and blood in the subarachnoid space, and she was diagnosed with eclampsia with reversible cerebral vasoconstrictive syndrome (RCVS). Conclusion: RCVS is a pregnancy-related cause of seizure that should remain on the differential for any patient presenting with a seizure in the peripartum period, especially with use of vasoconstrictive agents. Management is controversial but involves calcium channel blockers and magnesium sulfate, as well as avoidance of vasoconstrictive agents.

AB - Background: Eclampsia is a pregnancy complication characterized by generalized tonic-clonic convulsions. Not all seizures in pregnancy are eclamptic, and other causes include epilepsy, infection, stroke, tumor, and ruptured aneurysm. Case: A 19-year-old G1P0 presented in labor at term. She had a generalized tonic-clonic seizure one hour after vaginal delivery for which she received methergine for uterine atony. Seizure activity resolved with lorazepam and magnesium sulfate for presumed eclampsia. Brain imaging revealed vasoconstriction of the left posterior cerebral artery and blood in the subarachnoid space, and she was diagnosed with eclampsia with reversible cerebral vasoconstrictive syndrome (RCVS). Conclusion: RCVS is a pregnancy-related cause of seizure that should remain on the differential for any patient presenting with a seizure in the peripartum period, especially with use of vasoconstrictive agents. Management is controversial but involves calcium channel blockers and magnesium sulfate, as well as avoidance of vasoconstrictive agents.

KW - Blood pressure

KW - Hypertension

KW - Methergine

KW - Pregnancy

KW - Vasoconstriction

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U2 - 10.1016/j.preghy.2022.01.002

DO - 10.1016/j.preghy.2022.01.002

M3 - Letter

C2 - 35063759

AN - SCOPUS:85123108470

SN - 2210-7789

VL - 27

SP - 131

EP - 133

JO - Pregnancy Hypertension

JF - Pregnancy Hypertension

ER -

Eclampsia with RCVS: Postpartum seizure provoked by methergine

Abstract

Keywords

ASJC Scopus subject areas

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