[Postpartum dyspnoea : an inaugural and atypical manifestation of preeclampsia].

Abstract

Hypertensive disorders of pregnancy and recommendations for their management are currently well defined. However, postpartum manifestations are considerably less so. Postpartum preeclampsia is a poorly studied pathological entity. It is not certain whether it is a distinct entity from antenatal preeclampsia. Diagnostic criteria include the new onset of hypertension within 48 hours to 6 weeks after delivery, associated with at least one other clinical or biological criterion. Most cases of postpartum preeclampsia occur within 7 to 10 days after delivery. Risk factors are similar to those of antenatal preeclampsia. Neurological signs such as headaches are the most common clinical manifestations. Atypical symptoms such as dyspnea should prompt consideration of different diagnoses, including postpartum cardiomyopathy and pulmonary embolism. Management of postpartum preeclampsia is essential to limit its impact on maternal morbidity and mortality. It primarily relies on antihypertensive treatment, possibly including diuretics and magnesium sulfate. Here we report a case of postpartum preeclampsia revealed by worsening dyspnoea, leading the patient to the emergency department on the 9th day postpartum.