Posterior Reversible Encephalopathy Syndrome during Pregnancy: A Case Report

Background: Posterior reversible encephalopathy syndrome (PRES) is a neurological condition entity presenting with headache, confusion, seizure, altered mentation and loss of vision associated with white matter changes on imaging. The lesions in PRES are thought to be due to vasogenic edema, mainly in the posterior cerebral hemispheres. Cases Report: This study has reported a patient who developed PRES without any indicators for preeclampsia-eclampsia in her pregnancy. The patient’s brain images showed abnormal signal intensity in the occipital lobe. Conclusion: Posterior reversible encephalopathy syndrome is reversible when initial diagnosis established and suitable treatment start immediately

25-Hydroxy Vitamin D Level and Its Correlation with Mean Platelet Volume in Preeclampsia

Background: Preeclampsia is one of the challenging complications of pregnancy, of which little is known about its etiology and pathogenesis. Many studies have shown higher mean platelet volume (MPV) in preeclamptic patients. Vitamin D deficiency is in association with larger-size platelets. Thus, we aimed to determine the correlation of vitamin D with MPV in preeclamptic patients. Methods: This prospective case–control study was conducted in two tertiary hospitals in Tehran, Iran. Overall, 85 preeclamptic pregnant women and 85 normotensive pregnant women were entered between 2017 and 2018. Serum vitamin D concentration (ng/ml) and MPV (femtoliter) were measured for all patients. Results: MPV was significantly higher in the cases compared to controls (10.59±1.08 vs 8.10±0.95, P=0.0001). In addition, serum vitamin D level in the preeclamptic group was significantly lower in compare to the control group (17.79±11.03 vs 30.24±12.49; P=0.0001). In multivariate logistic regression analysis, high age of mother (OR: 1.13; 95% CI: 1.01-1.27; P=0.03), low level of serum vitamin D (OR: 0.93; 95% CI: 0.87-0.99; P=0.02) and high MPV (OR: 8.83; 95% CI: 4.17-18.67; P=0.0001) were independent predictors of preeclampsia. Moreover, a correlation analysis revealed that vitamin D levels correlated negatively with MPV (r= -0.41, P<0.0001). Conclusion: Low levels of vitamin D in preeclamptic pregnancy are associated with higher platelet activity and thrombosis. In fact, the increment of MPV level might be a potential pathway for adverse outcomes of pregnancy including preeclampsia in the context of vitamin D deficiency.