Title: Brain CT scans findings in Eclampsia mothers and its clinical evaluation: A cross sectional study
Authors: Dr Anjan Dasgupta, Dr Suman Kumar Biswas, Prof. Swapan Kumar Jana, Dr Debabrata Nandy
Eclampsia, the sudden occurrence of tonic-clonic seizure and/ or coma without previous neurological disorder is a life threatening complications of pregnancy. The exact cause is still ill understood and recent studies using computed tomography (CT scan) and MRI helped to better understand the neuro-imaging findings and their correlation with various neurological symptoms in eclampsia.
Aims & Objectives: The objective of the study is to evaluate the characteristics of different neurological findings and changes observe in brain through CT scan in eclampsia mothers, so that early intervention in pathological brain lesion may help to reduce maternal and perinatal morbidity and mortality.
Materials & Methods: It was a hospital based cross sectional study with ethical approval. Eclampsia mothers who were admitted in indoor during one year were included (n=69) with relevant history taking, examination, essential investigations including CT scan of the brain and results were analyzed at the end of the study. CT scans were done preferably within 72 hours of first convulsion. Those patients who were hypertensive before pregnancy or known epileptic were excluded. The MgSo4 regime and antihypertensive were used accordingly as per book teaching.
Result & Analysis: A total of 69 eclampsia mothers were studied and CT scan of brain was performed earliest possible; Maximum number of mothers was in the age group of 17-20 years. The mean systolic and diastolic blood pressure was 166+/- 14 mmHg and 106+/-11 mmHg respectively. CT scan findings showed that almost 50% of patient had brain edema, 17.4% with ischemia, few with hemorrhage, hematoma and granuloma; 17.4% had no brain lesion. Those mothers who attended antenatal clinic regularly has comparatively less pathological brain lesion than who did not (p value 0.048). Patient who has visual disturbances, CT scan showed more parietal lobe involvement than any other area of brain (p value 0.017). Regarding levels of consciousness, CT scan finding has shown that pathological brain lesion has found to be more in semiconscious and unconscious group (p value 0.028). Those who have severe neurological impairment with GCS (Glasgow Coma Scale) score 0-8, CT scan showed pathological brain lesion in them (p value 0.001). It is interesting to note that, mothers who required extra dose of MgSo4 to control convulsions, CT scan also showed pathological brain lesions in them (p value 0.024).
Conclusion: Application of CT scan can be a preferred way to diagnose and detect other coexisting brain lesion in eclampsia mothers and thus could be helpful in reducing maternal and perinatal mortality.
Keywords: CT scan, Brain lesion, Eclampsia.