The incidence of "posterior reversibl encephalopathy syndrome (PRES)" observed in preeclampsia-eclampsy-HELLP diagnosed pregnancy

Aim: The aim of our study is to investigate the incidence of posterior reversible encephalopathy syndrome (PRES) with MR in pregnant women followed up with preeclampsia, eclampsy and HELLP syndrome in our Mustafa Kemal University Practice and Research Hospital Gynecology and Obstetrics clinic. Method: After the approval of the ethics committee, 844 pregnant women who gave birth in HMKU hospital between November 2019 and November 2020 prospectively; peripartum MR was performed on 39 pregnant women who were diagnosed with preeclampsia, eclampsia and HELLP. These 39 patients were examined in 2 groups as patients with normal imaging and PRES findings on MR. Results:Peripartum MR was performed in 39 (4.6%) of 844 pregnant women with the diagnosis of preeclampsia, eclampsia and hellp. Of these 39 patients, 28 (3.3%) were in our follow-up due to preeclampsia and 7 (0.8%) due to eclampsia. PRES was reported in 10 (25.6%) of these 39 patients (1.1% of all deliveries). Of these 10 PRES patients, 5 had eclampsia, 4 had preeclampsia, and 1 had eclampsia+hellp. PRES was found in 71.4% of 39 patients who were diagnosed with eclampsia and 14.3% of those with preeclampsia. PRES was not observed in 2 patients with HELLP syndrome. A significant correlation was found between the diagnoses of the patients and the prevalence of PRES (p=0.012). According to our study, PRES diagnosis was found to be significantly higher in patients in the low age group (p=0.040). While the median age is 28.0 in patients with normal MR results, it is 23.5 in patients with PRES. In our study, it was found that patients diagnosed with PRES had a significantly longer hospital stay than the others (p=0.001). The median length of hospital stay of patients diagnosed with PRES was 6.5 days, while it was 3 days for the others. Among our patients, the incidence of PRES was found to be significantly higher in patients who had seizures compared to those who did not have seizures. The incidence of PRES in patients with seizures is 62.5%, while it is 16.1% in patients who do not have seizures (p=0.011). Conclusion:Since the incidence of PRES is very high in preeclamptic and eclamptic pregnant women with prodromal symptoms, early diagnosis and treatment should be provided by imaging method. Keywords:PRES, preeclampsia, eclampsy, HELLP