CASE STUDY
A previously healthy 31-year primigravida developed weakness of
bilateral lower limbs and paresthesia at 36 weeks of pregnancy. Her
antenatal period was unremarkable. She was admitted in the hospital and
diagnosed to have peripheral neuropathy. On the day of admission, her
hemoglobin was 9.8 gm/dl. Her liver function test and renal function
test were within normal limits except for hyperchloremia (115 mEq/L
(Normal; 96-110 mEq/L). Her urine albumin and urine glucose using
dipstick was nil. She was treated with vitamin B complex tablets along
with tablet thiamine 75 mg twice a day. She also received Neurobion
injection (Vitamin B complex). She delivered a healthy male baby at
37+ 5 weeks of pregnancy. The postpartum period was
unremarkable and she was subsequently discharged as case of peripheral
neuropathy with vitamin B. complex tablet and thiamine tablet.
On postpartum day 5, she presented with complaints of bilateral leg
swelling. On examination, she had weakness of bilateral legs with power
of 4/5. She was found to have high blood pressure of 180/120 with pedal
oedema (+++). She denied having symptoms of severe headache, shortness
of breath or visual disturbances. Her hemoglobin was 10 g/dl with normal
renal and liver function tests. Her blood platelets were also within the
normal limits. The urine analysis showed urine albumin of 2+. She was
started on tablet Losartan 50 mg twice a day, Tablet furosemide 40 mg
once a day and Tablet Nifedipine 20 mg once a day. She was treated as a
case of postpartum preeclampsia. During the course of her admission, she
also received tablet Vitamin B complex, tablet thiamine 75 mg bd and
injection Cyanocobalamin 1 mg od.
Her blood pressure decreased on day 4 of admission and her urine albumin
also became negative. Her symptoms subsided and she was subsequently
discharged.