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.