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Eclampsia in a multipara without prior history of preeclampsia / eclampsia

Author: 
Prilly Astari and Ong Tjandra
Subject Area: 
Health Sciences
Abstract: 

Background: Preeclampsia (PE) occurs in 2-8% of all pregnancies and mostly happens in the first pregnancy. The risk of developing PE in a third pregnancy (multipara) without a previous PE / E history is very small, especially if it occurs at under 34 weeks of gestation. Objective: To report a case of eclampsia in a multipara without prior history of preeclampsia / eclampsia. Methods: Case report. Results: A 32-year-old woman G3P2A0 with 32-33 weeks' gestation, came to the Tangerang Bethsaida Hospital emergency room with a history of seizure at home. Vital signs at the time of arrival showed blood pressure of 180/110 mmHg, pulse of 140 x/minute, respiratory rate of 20 x/minute, temperature of 36.50C, and oxygen saturation of 99%. Physical examination revealed minimal edema in lower extremities. ECG showed tachycardia, FHR using CTG was 140 x / minute, laboratory results showed urine protein 75mg / dL, triglycerides 537mg / dL, uric acid 11.5mg / dL, leukocytes 18,340 / μL, other CBC results along with HBA1C, albumin, AST, ALT, blood glucose, urea, creatinine, serum electrolytes (Na, K, Cl), bleeding time, clotting time, PT, and APTT were normal. Patient routinely comes for antenatal care. There was no history of preeclampsia/eclampsia during the first and second pregnancies. She was admitted to the ICU and diagnosed as eclampsia, received Adalat oros therapy, Aldomet, Perdipine, MgSO4, Dexamethasoneinjection for 24 hours for lung maturation, as well as pregnancy termination. After 24 hours in the ICU, cesarean operation and tubectomy were performed, a 1,495 gram baby boy was born, length 39 cm, APGAR score 3/8. The patient was treated with antibiotics, antihypertension, and vitamins. She was hospitalized for 3 days. Conclusions:We reported one case of a woman with the third pregnancy (multipara) of 32-33 weeks’ gestation with eclampsia without history of PE / E in both previous pregnancies. This is a very rare case, however with proper management, good outcomes can be achieved for both the mother and baby.

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