{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:49:25Z","timestamp":1789044565836,"version":"build-2803163510"},"reference-count":60,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:p>Introduction: Preeclampsia and eclampsia are hypertensive disorders of pregnancy associated with significant maternal and fetal morbidity and mortality. Posterior reversible encephalopathy syndrome (PRES) is a neurological complication observed in these conditions, yet its impact on fetomaternal outcomes remains underexplored. The aim of this study is to investigate the association between PRES and fetomaternal outcomes in women with preeclampsia and eclampsia.<\/jats:p>\n                  <jats:p>Methods: This prospective cohort study enrolled 64 singleton pregnant women beyond 20 weeks of gestation with preeclampsia and eclampsia having neurological symptoms. Participants underwent clinical evaluation and radiological assessment, including non-contrast computed tomography (NCCT) and magnetic resonance imaging (MRI). Maternal outcomes, including high dependency unit (HDU)\/intensive care unit (ICU) stay, intubation, mode of delivery and maternal mortality. Fetal outcomes, i.e., stillbirth, prematurity, and neonatal intensive care unit (NICU) stay, were recorded. Statistical analysis was performed to compare outcomes between PRES and non-PRES groups.<\/jats:p>\n                  <jats:p>\n                    Results: The majority (92.18%) of participants were unscheduled and (56.2%) were primigravida. PRES was diagnosed in 62.5% of cases, predominantly associated with antepartum eclampsia (47.5%). Neurological symptoms such as headache (85.9%) and blurring of vision (68.8%) were common in PRES cases. Cesarean section rate was significantly higher in PRES group (75%), along with adverse outcomes including increased HDU\/ICU stay, intubation, postpartum haemorrhage (PPH), abruption, maternal mortality, stillbirth, prematurity, fetal growth restriction (FGR), meconium-stained liquor (MSL), and NICU stay, which were observed significantly higher in women with PRES (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001) and low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05). However, no significant association was observed between PRES and early neonatal death (ENND).\n                  <\/jats:p>\n                  <jats:p>Conclusion: PRES is associated with adverse fetomaternal outcomes in women with preeclampsia\/eclampsia, including higher cesarean section rate and increased maternal and neonatal morbidity. Early recognition and management of PRES are crucial for improving outcomes in these high-risk pregnancies. Further research with larger sample sizes is warranted to validate these findings and explore potential interventions.<\/jats:p>","DOI":"10.5339\/qmj.2024.59","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T09:30:57Z","timestamp":1733823057000},"source":"Crossref","is-referenced-by-count":2,"title":["Fetomaternal outcome in preeclampsia and eclampsia with posterior reversible encephalopathy syndrome"],"prefix":"10.5339","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0472-9048","authenticated-orcid":true,"given":"Upma","family":"Saxena","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salimun","family":"Nisa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4109-8705","authenticated-orcid":true,"given":"Yatish","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4339-2070","authenticated-orcid":true,"given":"Abhishek","family":"Lachyan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Chandan","sequence":"additional","affiliation":[{"name":"Department of Neurology, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4028-489X","authenticated-orcid":true,"given":"Sidarrth","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA*Correspondence: Upma Saxena drupmasaxena@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"key":"CIT0001","article-title":"Preeclampsia. In: StatPearls","author":"Karrar\n \nSA","year":"2023"},{"key":"CIT0002","article-title":"Hypertension in pregnancy [Updated 2022 Oct 3]. In: StatPearls","author":"Luger\n \nRK","year":"2024"},{"issue":"(6):","key":"CIT0003","series-title":"Obstet Gynecol","first-page":"e237\u201360","article-title":"Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222","volume":"135","year":"2020"},{"issue":"(1):","key":"CIT0004","series-title":"Qatar Med J","first-page":"4","article-title":"Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes","volume":"2021","author":"Shaikh\n \nN","year":"2021"},{"key":"CIT0005","series-title":"Neurol India","first-page":"1316\u201323","article-title":"Posterior reversible encephalopathy syndrome in eclampsia","volume":"66","author":"Garg\n \nRK","year":"2018;"},{"key":"CIT0006","series-title":"BMC Neurol","first-page":"30","article-title":"Establishment and utility assessment of posterior reversible encephalopathy syndrome early warning scoring (PEWS) scale establishment and utility assessment of PEWS scale","volume":"19","author":"Zou\n \nL-P","year":"2019;"},{"key":"CIT0007","series-title":"BMC Pregnancy Childbirth","first-page":"336","article-title":"Severe pre-eclamptic women with headache: Is posterior reversible encephalopathy syndrome an associated concurrent finding?","volume":"20","author":"Chao\n \nAS.","year":"2020;"},{"key":"CIT0008","series-title":"Pract Neurol","first-page":"183\u20139","article-title":"Posterior reversible encephalopathy syndrome (PRES): Diagnosis and management","volume":"22","author":"Triplett\n \nJD","year":"2022;"},{"issue":"(6):","key":"CIT0009","series-title":"Am J Neuroradiol","first-page":"1036\u201342","article-title":"Posterior reversible encephalopathy syndrome, part 1: Fundamental imaging and clinical features","volume":"29","author":"Bartynski\n \nWS","year":"2008;"},{"key":"CIT0010","series-title":"J Neurol","first-page":"1608\u201316","article-title":"Posterior reversible encephalopathy syndrome","volume":"264","author":"Fischer\n \nM","year":"2017;"},{"key":"CIT0011","series-title":"Lancet Neurol","first-page":"914\u201325","article-title":"Posterior reversible encephalopathy syndrome: Clinical and radiological manifestations, pathophysiology, and outstanding questions","volume":"14","author":"Fugate\n \nJE","year":"2015;"},{"key":"CIT0012","series-title":"Oxf Med Case Rep","first-page":"omx011","article-title":"Posterior reversible encephalopathy syndrome (PRES)","volume":"2017","author":"Sudulagunta\n \nSR","year":"2017;"},{"key":"CIT0013","series-title":"Curr Hypertens Rep","first-page":"64","article-title":"Cerebrovascular dysfunction in preeclamptic pregnancies","volume":"17","author":"Hammer\n \nES","year":"2015;"},{"issue":"(5):","key":"CIT0014","series-title":"Arch Gynecol Obstet","first-page":"1013\u20138","article-title":"Clinical and perinatal outcomes in eclamptic women with posterior reversible encephalopathy syndrome","volume":"292","author":"Kurdoglu\n \nZ","year":"2015;"},{"issue":"(11):","key":"CIT0015","series-title":"Cureus","first-page":"e31459","article-title":"Predictors of posterior reversible encephalopathy syndrome (PRES) in women with pre-eclampsia\/eclampsia: A retrospective analysis","volume":"14","author":"Bahadur\n \nA","year":"2022;"},{"issue":"(7):","key":"CIT0016","series-title":"J Clin Diagn Res","first-page":"QC05\u20137","article-title":"A study of eclampsia cases associated with posterior reversible encephalopathy syndrome","volume":"9","author":"Bembalgi\n \nS","year":"2015"},{"issue":"(12):","key":"CIT0017","series-title":"Hypertens Res","first-page":"982\u20137","article-title":"A study on clinicoradiological characteristics and pregnancy outcomes of reversible posterior leukoencephalopathy syndrome in preeclampsia or eclampsia","volume":"40","author":"Fang\n \nX","year":"2017;"},{"issue":"(1):","key":"CIT0018","series-title":"BMC Pregnancy Childbirth","first-page":"336","article-title":"Severe pre-eclamptic 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Gynecol","first-page":"e239\u201340","article-title":"Incidence of posterior reversible encephalopathy syndrome in eclamptic and patients with preeclampsia with neurologic symptoms","volume":"215","author":"Mayama\n \nM","year":"2016;"},{"issue":"(4):","key":"CIT0030","series-title":"Obstet Med","first-page":"236\u201341","article-title":"A systematic review of posterior reversible encephalopathy syndrome in pregnant women with severe preeclampsia and eclampsia","volume":"16","author":"Tawati\n \nDA","year":"2023;"},{"key":"CIT0001","article-title":"Preeclampsia. 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scale","volume":"19","author":"Zou\n \nL-P","year":"2019;"},{"key":"CIT0007","series-title":"BMC Pregnancy Childbirth","first-page":"336","article-title":"Severe pre-eclamptic women with headache: Is posterior reversible encephalopathy syndrome an associated concurrent finding?","volume":"20","author":"Chao\n \nAS.","year":"2020;"},{"key":"CIT0008","series-title":"Pract Neurol","first-page":"183\u20139","article-title":"Posterior reversible encephalopathy syndrome (PRES): Diagnosis and management","volume":"22","author":"Triplett\n \nJD","year":"2022;"},{"issue":"(6):","key":"CIT0009","series-title":"Am J Neuroradiol","first-page":"1036\u201342","article-title":"Posterior reversible encephalopathy syndrome, part 1: Fundamental imaging and clinical features","volume":"29","author":"Bartynski\n \nWS","year":"2008;"},{"key":"CIT0010","series-title":"J Neurol","first-page":"1608\u201316","article-title":"Posterior reversible encephalopathy syndrome","volume":"264","author":"Fischer\n \nM","year":"2017;"},{"key":"CIT0011","series-title":"Lancet Neurol","first-page":"914\u201325","article-title":"Posterior reversible encephalopathy syndrome: Clinical and radiological manifestations, pathophysiology, and outstanding questions","volume":"14","author":"Fugate\n \nJE","year":"2015;"},{"key":"CIT0012","series-title":"Oxf Med Case Rep","first-page":"omx011","article-title":"Posterior reversible encephalopathy syndrome (PRES)","volume":"2017","author":"Sudulagunta\n \nSR","year":"2017;"},{"key":"CIT0013","series-title":"Curr Hypertens Rep","first-page":"64","article-title":"Cerebrovascular dysfunction in preeclamptic pregnancies","volume":"17","author":"Hammer\n \nES","year":"2015;"},{"issue":"(5):","key":"CIT0014","series-title":"Arch Gynecol Obstet","first-page":"1013\u20138","article-title":"Clinical and perinatal outcomes in eclamptic women with posterior reversible encephalopathy syndrome","volume":"292","author":"Kurdoglu\n \nZ","year":"2015;"},{"issue":"(11):","key":"CIT0015","series-title":"Cureus","first-page":"e31459","article-title":"Predictors of posterior reversible encephalopathy syndrome (PRES) in women with pre-eclampsia\/eclampsia: A retrospective analysis","volume":"14","author":"Bahadur\n \nA","year":"2022;"},{"issue":"(7):","key":"CIT0016","series-title":"J Clin Diagn Res","first-page":"QC05\u20137","article-title":"A study of eclampsia cases associated with posterior reversible encephalopathy syndrome","volume":"9","author":"Bembalgi\n \nS","year":"2015"},{"issue":"(12):","key":"CIT0017","series-title":"Hypertens Res","first-page":"982\u20137","article-title":"A study on clinicoradiological characteristics and pregnancy outcomes of reversible posterior leukoencephalopathy syndrome in preeclampsia or eclampsia","volume":"40","author":"Fang\n \nX","year":"2017;"},{"issue":"(1):","key":"CIT0018","series-title":"BMC Pregnancy Childbirth","first-page":"336","article-title":"Severe pre-eclamptic 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\nJ","year":"2013;"},{"key":"CIT0022","series-title":"Front Neurol","first-page":"71","article-title":"Posterior reversible encephalopathy syndrome: Clinical features and outcome","volume":"11","author":"Hinduja\n \nA","year":"2020;"},{"issue":"(7):","key":"CIT0023","series-title":"Eur J Neurol","first-page":"935\u201343","article-title":"Clinical and radiological differences in posterior reversible encephalopathy syndrome between patients with preeclampsia-eclampsia and other predisposing diseases: PRES in preeclampsia\/eclampsia","volume":"19","author":"Liman\n \nTG","year":"2012;"},{"key":"CIT0024","series-title":"Pregnancy Hypertens","first-page":"74\u201382","article-title":"Posterior encephalopathy syndrome in women with eclampsia: Predictors and outcome","volume":"10","author":"Verma\n \nAK","year":"2017;"},{"issue":"(2):","key":"CIT0025","series-title":"Hypertens Res","first-page":"112\u20137","article-title":"Effect of blood pressure on reversible posterior leukoencephalopathy 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