Intracranial haemorrhage due to decompensationof hypertension in severe preeclampsia with the needof a hysterectomy – case report

Czech version

Authors: N. Nguyen Duc; D. Drmlová; Š. Urbánek
Authors‘ workplace: Gynekologicko-porodnické oddělení, Oblastní nemocnice Kladno, a. s., primář MUDr. P. Ullrych
Published in: Ceska Gynekol 2016; 81(1): 27-30

Overview

Objective:
To present a case of intracranial haemorrhage due to decompensated hypertension in case of severe preeclampsia which resulted in acute caesarean section followed by hysterectomy.

Design:
Case report.

Setting:
Department of Obstetrics and Gynaecology, Hospital Kladno.

Case report:
We report the case of a 36-year old multiparous woman in the 35th week of pregnancy with no prenatal care. According to her medical history, she had a caesarean section three years earlier and six previous spontaneous deliveries without complications (including spontaneously delivered twins). She underwent three abortions and one spontaneous miscarriage. This patient arrived to our department in serious condition with critical values of blood pressure, strong headache, impaired vision, dysarthria and right hemiparesis. In cooperationwith a neurologist we performed an acute native brain CT which revealed an acute intracranial haemorrhage. According to the neurosurgeon, this finding was not suitable for neurosurgical intervention. The patient was indicated for acute caesarean section. Due to heavy bleeding during the caesarean section, a hysterectomy was performed.

Conclusion:
In presenting this serious case of preeclampsia, the authors want to emphasize the need for early diagnosis, interdisciplinary cooperation, sufficient treatment and knowledge of surgical interventions such as abdominal hysterectomy, as a final solution for a life-threatening perinatal haemorrhage.

KEYWORDS:
preeclampsia, hysterectomy after caesarean section, intracranial haemorrhage

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