Hypertensive disorders during pregnancy can lead to postpartum eclampsia and neurological complications such as posterior reversible encephalopathy syndrome (PRES). We report 2 cases of postpartum eclampsia in twin pregnancies, both presenting with seizures following acute blood pressure elevation after cesarean delivery. Brain magnetic resonance imaging confirmed PRES in both patients, showing characteristic T2 fluid-attenuated inversion recovery hyperintensities. Treatment with magnesium sulfate and levetiracetam resulted in symptom resolution and radiologic recovery. These cases emphasize the importance of continuous postpartum monitoring in women with preeclampsia or persistent proteinuria to prevent serious neurological complications.
Kwak et al. (Thu,) studied this question.