• Am J Emerg Med · Oct 2017

    Case Reports

    Late onset postpartum preeclampsia: Is it time to reconsider if it's really too late?- A case of preeclampsia 3 months after delivery.

    • Al Giwa and Melissa Nguyen.
    • Martin Army Community Hospital, Department of Emergency Medicine, Fort Benning, GA, USA. Electronic address: al@bema.nyc.
    • Am J Emerg Med. 2017 Oct 1; 35 (10): 1582.e1-1582.e3.

    AbstractPreeclampsia is defined by the American College of Obstetrics and Gynecology (ACOG) as "the occurrence of new onset hypertension plus new-onset proteinuria" [1]. Up-to-Date elaborates a little further on this by defining preeclampsia as "the new onset of hypertension and proteinuria, or hypertension and end-organ dysfunction with or without proteinuria, after 20 weeks of gestation in a previously normotensive woman. It may also develop postpartum. Severe hypertension or signs/symptoms of end-organ injury represent the severe end of the disease spectrum" [2] In 2013, the American College of Obstetricians and Gynecologists removed proteinuria as a key component in the diagnosis of preeclampsia. They also removed massive proteinuria (previously, 5 g/24 hours) and fetal growth restriction as possible features of severe disease. They found that were was a poor correlation in many outcomes between massive proteinuria and fetal growth restriction when managed similarly, with or without preeclampsia as a diagnosis. Oliguria was also removed as a characteristic of severe disease. [3] There have been several cases reported in the literature as well as by Obstetricians citing the incidence of preeclampsia occurring upwards of 6 to even 12 weeks postpartum. We hope to demonstrate what we believe to be a case of postpartum preeclampsia at 89 days postpartum.Published by Elsevier Inc.

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