Abstract: Introduction: Posterior Reversible Encephalopathy Syndrome (PRES) is a reversible clinicoradiological condition characterized by vasogenic edema, predominantly in the posterior cerebral hemispheres, and is frequently associated with hypertensive disorders in obstetrics, such as preeclampsia and eclampsia. Its recognition is critical due to its potential for significant maternal morbidity if untreated.
Objectives: This study aimed to investigate the pathophysiology, clinical presentation, diagnostic features, and management outcomes of PRES in obstetric patients, with a focus on a small cohort (n = 9) over a two-year period, to enhance understanding and guide clinical practice in this high-risk population.
Methods: A retrospective observational study was conducted at a tertiary obstetric center from March 2023 to March 2025. Nine pregnant or postpartum women diagnosed with PRES via clinical symptoms (e.g., seizures, headache) and MRI-confirmed bilateral posterior hyperintensities were included. Data on demographics, clinical features, laboratory findings, treatments, and outcomes were analyzed descriptively due to the small sample size.
Results: All 9 patients had preeclampsia or eclampsia, with seizures (77.8%), headache (66.7%), and visual disturbances (55.6%) as predominant symptoms. Mean systolic blood pressure at diagnosis was 172±15 mmHg. Management with antihypertensives (labetalol or hydralazine) and magnesium sulfate achieved symptom resolution within a median of 5 days (IQR: 3-7 days), with radiographic resolution in 8 patients (88.9%) at 4-6 weeks. One patient exhibited persistent mild memory deficits.
Discussion: Findings align with PRES’s association with hypertensive crises in obstetrics, highlighting seizures as a key feature and the efficacy of standard therapies. The small cohort limits generalizability, but outcomes suggest reversibility with prompt intervention, though long-term effects warrant further study.
Conclusion: PRES in obstetrics is manageable with early diagnosis and treatment, emphasizing the need for vigilance and multidisciplinary care. Larger studies are needed to refine predictive and therapeutic approaches.
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