Hypertension in Pregnancy, Early Online:1–5, 2010 Copyright © Informa UK Ltd. ISSN: 1064-1955 print / 1525-6065 online DOI: 10.3109/10641955.2010.506231 LHIP 1064-1955 1525-6065 Hypertension in Pregnancy, Vol. 1, No. 1, Jul 2010: pp. 0–0 Hypertension in Pregnancy CASE REPORT Low Neonatal Birth Weight as a Possible Predictive Factor for the Onset of Postpartum Eclampsia Neonatal Low Birth Weight and Postpartum Eclampsia Tersigni et al. Chiara Tersigni, 1 Giuseppe Esposito, 2 Alessio Albanese, 2 Silvia D’Ippolito, 1 Giovanni Sabatino, 2 Nicoletta Di Simone, 1 and Alessandro Caruso 1 1 Institute of Obstetrics and Gynaecology, Catholic University School of Medicine, Rome, Italy 2 Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy Objective. To report about a case of complicated late postpartum eclampsia where neo- natal low birth weight could be considered a predictive factor of placental sufferance. Methods. A 25-year-old woman, without medical or familiar history for hypertension or cerebrovascular diseases, underwent a normal spontaneous delivery with neonatal birth weight of 2340 g (9th percentile). Eight days later the patient presented sudden headache and generalized tonic–clonic seizures. Results. Blood hypertension and alter- ations in laboratory studies were detected; a diagnosis of late postpartum eclampsia was made. A CT scan showed subarachnoid hemorrhage (Hunt and hess grade I, Fisher grade III). Serial cerebral angiograms did not show any intracranial vascular malformations; epilepsy and hypertension were successfully medically treated; and a repeat CT examination showed the gradual resolution of subarachnoid hemorrhage. Headache progressively disappeared. Conclusions. Low neonatal birth weight could be linked to placental dysfunction and considered as a predictive factor for the onset of postpartum preeclampsia/eclampsia. We recommend a careful clinical and laboratory management of puerperium up to the first month postpartum, in particular in cases of “sine causa” neonatal low birth weight. Keywords Puerperium, Preeclampsia, Eclampsia, Low birth weight, Subarachnoid hemorrhage. INTRODUCTION Preeclampsia (PE) is defined as the occurrence of hypertension and pro- teinuria during pregnancy or puerperium. It occurs in 3–5% of all pregnan- cies, generally in nulliparae after 20 gestational weeks (1). When associated to seizures not related to other causes, this pathological condition is defined as “eclampsia.” However, eclampsia can also manifest without signs of PE: from 33 to 69% of patients with postpartum eclampsia may have no evidence of PE in the ante- or peripartum period (2). Eclampsia complicates 0.05–0.2% of Address correspondence to Chiara Tersigni, MD, Institute of Obstetrics and Gynaecology, Catholic University School of Medicine, L.go A. Gemelli, 8 – 00168 Rome, Italy. E-mail: acaruso@rm.unicatt.it Hypertens Pregnancy Downloaded from informahealthcare.com by Universita Cattolica Sacro Cuore on 10/22/10 For personal use only.