Putri RWY, Mahroos RE. Atypical eclampsia at primary health care in a remote area: A case report. World J Obstet Gynecol 2023; 12(4): 45-50 [DOI: 10.5317/wjog.v12.i4.45]
Corresponding Author of This Article
Rifka Wangiana Yulia Putri, MD, Doctor, Department of Medicine, Muhammadiyah University of Surakarta, St. A. Yani, Pabelan, Kartasura, Central Java, Sukoharjo 57169, Indonesia. rifkawangianayuliaputri@gmail.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Obstet Gynecol. Dec 28, 2023; 12(4): 45-50 Published online Dec 28, 2023. doi: 10.5317/wjog.v12.i4.45
Atypical eclampsia at primary health care in a remote area: A case report
Rifka Wangiana Yulia Putri, Rifda El Mahroos
Rifka Wangiana Yulia Putri, Department of Medicine, Muhammadiyah University of Surakarta, Central Java, Sukoharjo 57169, Indonesia
Rifda El Mahroos, Department of Physiology, The National Development Veteran University of East Java, East Java, Surabaya 60294, Indonesia
Author contributions: Putri RWY contributed to manuscript writing and editing, and data collection; Putri RWY and Mahroos RE contributed to data analysis; Mahroos RE contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rifka Wangiana Yulia Putri, MD, Doctor, Department of Medicine, Muhammadiyah University of Surakarta, St. A. Yani, Pabelan, Kartasura, Central Java, Sukoharjo 57169, Indonesia. rifkawangianayuliaputri@gmail.com
Received: October 5, 2023 Peer-review started: October 5, 2023 First decision: October 9, 2023 Revised: November 4, 2023 Accepted: November 17, 2023 Article in press: November 17, 2023 Published online: December 28, 2023 Processing time: 83 Days and 16.7 Hours
Abstract
BACKGROUND
Eclampsia is a generalized tonic-clonic seizure induced by pregnancy. It contributes to a high rate of maternal and neonatal morbidity and mortality worldwide. Eclampsia is characterised by classic signs such as elevated blood pressure, proteinuria, and seizures. However, it may occur in the absence of hypertension and/or proteinuria. The uncommon appearance of eclampsia makes it difficult to immediately assess and treat it. In addition, the occurrence of this case in a remote area makes it more challenging to handle. The objective of this case report is to increase awareness of uncommon manifestations of eclampsia, particularly in limited-resource settings.
CASE SUMMARY
A young primigravida experienced a generalised seizure without hypertension and/or proteinuria. Sudden hearing loss, blurred vision, and vomiting were complained about before the seizure attack. The patient was diagnosed with eclampsia. A loading dose of magnesium sulphate was administered immediately. The patient was referred from community healthcare to a hospital and discharged without any complications.
CONCLUSION
Atypical eclampsia may be a diagnostic challenge. However, other symptoms may be beneficial, such as awareness of eclampsia signs.
Core Tip: Generalized seizures are the hallmark of eclampsia, along with high blood pressure and proteinuria. However, in some women, eclampsia could develop in the absence of proteinuria and hypertension. A seizure in pregnancy without hypertension and/or proteinuria is considered atypical eclampsia. Here, we report an atypical presentation of eclampsia, the generalised seizure without prior hypertension and proteinuria, experienced by a young primigravida in a primary healthcare centre located in a remote area. We found neurological disturbances and gastrointestinal symptoms were present as impending eclampsia symptoms. Magnesium sulphate is administered as the first line of eclampsia treatment.
