Pre-eclampsia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Differentiating Pre-eclampsia from other Diseases

. Another condition that may be confused with eclampsia or preeclampsia is reversible cerebral vasoconstriction syndrome (50). Reversible cerebral vasoconstriction syndrome is characterized by reversible multifocal narrowing of the arteries of the brain with signs and symptoms that typically include thunderclap headache and, less commonly, focal neurologic deficits related to brain edema, stroke, or seizure. Treatment of women with PRES and reversible cerebral vasoconstriction syndrome may include medical control of hypertension, antiepileptic medication and long-term neurologic follow-up. inaccurate. Nervous system manifestations frequently encountered in preeclampsia are headache, blurred vision, scotomata, and hyperreflexia. Although uncommon, temporary blindness (lasting a few hours to as long as a week) also may accompany preeclampsia with severe features and eclampsia (47). Posterior reversible encephalopathy syndrome (PRES) is a constellation of a range of clinical neurologic signs and symptoms such as vision loss or deficit, seizure, headache, and altered sensorium or confusion (48). Although suspicion for PRES is increased in the setting of these clinical features, the diagnosis of PRES is made by the presence of vasogenic edema and hyperintensities in the posterior aspects of the brain on magnetic resonance imaging. Women are particularly at risk of PRES in the settings of eclampsia and preeclampsia with headache, altered consciousness, or visual abnormalities (49). Another condition that may be confused with eclampsia or preeclampsia is reversible cerebral vasoconstriction syndrome (50). Reversible cerebral vasoconstriction syndrome is characterized by reversible multifocal narrowing of the arteries of the brain with signs and symptoms that typically include thunderclap headache and, less commonly, focal neurologic deficits related to brain edema, stroke, or seizure. Treatment of women with PRES and reversible cerebral vasoconstriction syndrome may include medical control of hypertension, antiepileptic medication and long-term

Pre-eclampsia can mimic and be confused with many other diseases, including chronic hypertension, chronic renal disease, primary seizure disorders, gallbladder and pancreatic disease, immune or thrombotic thrombocytopenic purpura, and hemolytic-uremic syndrome. It must always be considered a possibility in any pregnant woman beyond 20 weeks of gestation. It is particularly difficult to diagnose when preexisting disease such as hypertension is present.