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Eclampsia includes an encephalopathy with seizures, proteinuria and diffuse intravascular coagulation, as well as accelerated hypertension, rather than a specific vessel occlusion (a lenticulostriate artery) or spasm as here. Epidemiological data are imperfect, but many studies suggest there is an increased risk of stroke compared with the non-pregnant state. Although all types of stroke are represented, most in this setting are, in fact, due to arterial events—but it is the risk of venous infarction postpartum which has been highlighted in the literature. The days following delivery are said, by some, to be especially associated with rebound hypertension but the timing of stroke associated with pregnancy is controversial and variable. The Cochrane review concluded there is no clear blood pressure level at which treatment should be started antenatally, no reliable evidence to guide care for these women, nor reasons to favour any particular drug, although beta-blockers are traditionally used.

The patient . . . [Full text of this article]