Neuro-imaging in severe hypertensive disorders of pregnancy and correlation with laboratory data: A study from North Indian tertiary health care institution

Cerebral & visual disturbances, epigastric pain, nausea, and vomiting, pulmonary edema, impaired liver function of unclear etiology & thrombocytopenia. RBC morphology is the strongest predictor of abnormal radiographic findings. The only laboratory parameter that has been found to be abnormal a week prior to the development of neurological symptoms is serum Lactate dehydrogenase (LDH) level which is higher in the group that later developed hypertensive encephalopathy related brain oedema. Alteration in Liver function tests (LFTs) includes elevated levels of serum aminotransferase, namely, aspartate aminotransferase (AST) or alanine aminotransferase (ALT). Methods: The study was conducted among 65 antenatal women diagnosed with pre-eclampsia and eclampsia at gestational age >20 weeks in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and child IGMC Shimla. Laboratory tests and neuroimaging findings were recorded for study purpose. Results: About 17.6% of severe pre-eclampsia and 100% of eclampsia had findings observed on cranial MRI. In subjects with MR imaging findings, hematocrit, LDH, serum uric acid and ApTT were significantly higher than those without MR imaging findings. Subjects with MRI finding had abnormal RBC morphology whereas none of MR negative subjects had abnormal RBC morphology.