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Late Postpartum Eclampsia: Examples and Review

Hirshfeld-Cytron, Jennifer MD*; Lam, Chun MD; Karumanchi, S Ananth MD; Lindheimer, Marshall MD§

Obstetrical & Gynecological Survey: July 2006 - Volume 61 - Issue 7 - p 471-480
doi: 10.1097/01.ogx.0000219564.65999.0d

Eclampsia, defined as the occurrence of seizures in pregnant women, usually in the setting of preeclampsia and in the absence of other neurologic disorders, occurs mainly before, during, or within 48 hours after delivery. When convulsions occur later postpartum, diagnosis is difficult and treatment disputed. We review the entity of late postpartum eclampsia and report 2 examples in which the serum levels of antiangiogenic and angiogenic proteins were measured.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to explain that late postpartum eclampsia can occur more than 48 hours and less than 4 weeks post delivery, state that it is important to have a comprehensive differential diagnosis, and recall that the signs and symptoms of postpartum eclampsia may differ from antepartum or intrapartum preeclampsia/eclampsia.

*Resident, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois; †Renal Fellow and ‡Assistant Professor, Departments of Medicine and Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; and §Professor Emeritus, Departments of Obstetrics and Gynecology and Medicine, Chicago Lying-In Hospital, Chicago, Illinois

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credits™ can be earned in 2006. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

Dr. Karumanchi is listed as a co-inventor on a patent filed by the Beth Israel Hospital for the use of angiogenic proteins in the diagnosis and treatment of preeclampsia. All other authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.

Lippincott Continuing Medical Education Institute, Inc. has identified and resolved all faculty conflicts of interest regarding this educational activity.

SAK is supported by NIH grants (DK065997 and HL079594).

Address correspondence to: Jennifer Hirshfeld-Cytron, MD, 5841 South Maryland Avenue, MC 2050, Chicago, IL 60637-1450. E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.