Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 53–156 119

improved referral of hypertensive women, and a reduced

Conclusions: There is strong support for screening and/or
proportion of women who had never previously had BP
diagnostic tests for preeclampsia and substantial willingness
measured in pregnancy (median gestation 35 weeks)
to participate in clinical trials.
(25.1–16.9%, OR 0.58, p = 0.001, CI 0.42–0.79).
Disclosures: C.J. Rogers: None. J. Hewison: None. E. Tsigas:
Conclusions: Equipping low-skilled community healthcare
None.
providers (cHCPs) with novel BP devices is feasible and
widely accepted, resulting in a significant rise in mean dia- doi:10.1016/j.preghy.2014.10.242
stolic BP and improved antenatal BP screening. Phase two
will evaluate the adapted device, which incorporates a traf-
fic light early warning system that alerts cHCPs to both
hypertension and shock, improving the detection of compro- [237-POS]
mise from obstetric haemorrhage and sepsis, as well as pre-
eclampsia. A multi-center institutional-level prospective
Postpartum eclampsia – A late presentation to keep in
study in South Africa will evaluate the value of the thresh-
mind
olds used for the traffic light early warning system to predict
Sara Nascimento, Rui Gomes, Teresa Matos, Isabel Santos,
adverse outcome, prior to a large community cluster RCT to
Fernanda Matos (Hospital Prof. Doutor Fernando
evaluate the introduction of the devices at a community-
Fonseca, EPE, Amadora, Portugal)
level on maternal and perinatal mortality and morbidity.
Disclosures: N.L. Hezelgrave: None. H.L. Nathan: None. K.E. Objectives: Presentation of two cases of late postpartum
Duhig: None. P.T. Seed: None. A.H. Shennan: None. eclampsia that took place at our hospital, one month apart.
Eclampsia is defined as generalized seizures, in the setting
doi:10.1016/j.preghy.2014.10.241 of preeclampsia, without other neurologic conditions. With
an incidence of 1:2.000 deliveries in developed countries,
it occurs in 2% of women with severe preeclampsia and in
[236-POS] 0.5% of those with non-severe preeclampsia. Although it
may occur from gestation to puerperium, it is estimated that
only 5–17% of cases take place after 48 h postpartum. While
Patient perspectives on screening/diagnostic tests, clini- eclampsia is a clinical diagnosis, most cases present with
cal trials, and expectant management for preeclampsia reversible posterior leukoencephalopathy syndrome (RPLS)
Caryn J. Rogers a, Jenny Hewison b, Eleni Tsigas a findings on MRI.
(a Preeclampsia Foundation, Melbourne, FL, USA, b Leeds Methods: Review of literature and consultation of clinical
Institute of Health Sciences, Leeds, United Kingdom) files.
Results: CASE 1 – A 28-year-old female, G2P0, underwent
Objectives: Preeclampsia and conditions such as HELLP
cesarean delivery, at 38 weeks’ gestation, in the setting of
complicate  5% of first pregnancies and are a leading cause
preeclampsia and abnormal nonstress test. On day 6 post-
of prematurity, maternal morbidity, and maternal and neo-
partum, she experienced sudden frontooccipital headache,
natal mortality and are linked to chronic disease in both
after which she had three generalized tonic–clonic seizures.
mother and child. The only treatment is delivery regardless
On admission, she was postictal and hypertensive (170/
of gestational age, the only therapy is LDA (thought to be of
120 mmHg), proteinuria 4+, normal CT scan and EEG. MRI
slight benefit to the very high-risk subset of the population),
revealed lesions compatible with PRLS. She was admitted
and no screening test exists. To evaluate attitudes, beliefs,
to the ICU and treated with magnesium sulfate, valproate
and values about screening/diagnostic tests, as well as risk
and antihypertensive medication, with no further seizures
tolerance for participation in clinical trials and approaches
and gradual normalization of blood pressure. CASE 2 – A
to expectant management, the Preeclampsia Foundation
31-year-old female, G5P3, with gestational hypertension,
conducted a pilot online survey of patient perspectives
underwent vaginal delivery at 40 weeks’ gestation. Since
around these issues of testing and care.
day 2 postpartum she complained of a mild headache. On
Methods: Women with and without complicated preg-
day 4 she developed blurred vision followed by generalized
nancy histories were recruited from the Preeclampsia Foun-
tonic–clonic seizure. At admission to the ICU, BP was 168/
dation’s patient network and asked to recruit other
110 mmHg. CT and EEG were normal. MRI revealed RPLS.
individuals with normal histories. They were invited to
She underwent therapy with magnesium sulfate, valproate
respond to an online survey via Zoomerang/Survey Monkey
and antihypertensive therapy, with no additional seizures
and to provide further comment on their views. Framework
and stabilization of blood pressure.
analysis of written answers was conducted and statistical
Conclusions: Prompt exclusion of other causes of seizures,
analysis (chi-square) of questions was performed. Main
especially in late presentations, combined with early diag-
themes were detected and classified.
nosis and treatment, are central to avoid morbidity and mor-
Results: Regardless of pregnancy history a clear majority
tality associated with eclampsia.
of women indicated they would value both screening and
Disclosures: S. Nascimento: None. R. Gomes: None. T.
diagnostic tests and would be willing to participate in trials.
Matos: None. I. Santos: None. F. Matos: None.
Women with a complicated history were much more likely
to endorse testing (p < .0001). Answers diverged on expec- doi:10.1016/j.preghy.2014.10.243
tant management questions.