RESUMEN

Postpartum headache is described as headache and neck or shoulder pain during the first 6 weeks after delivery. Common causes of headache in the puerperium are migraine headache and tension headache; other causes include pre-eclampsia/eclampsia, post-dural puncture headache, cortical vein thrombosis, subarachnoid hemorrhage, posterior reversible leukoencephalopathy syndrome, brain tumor, cerebral ischemia, meningitis, and so forth. Idiopathic intracranial hypertension (IIH) is a rare cause of postpartum headache. It is usually associated with papilledema, headache, and elevated intracranial pressure without any focal neurologic abnormality in an otherwise healthy person. It is more commonly seen in obese women of reproductive age group, but rare during pregnancy and postpartum. We present a case of IIH who presented to us 18 days after cesarean section with severe headache and was successfully managed.

Asunto(s)

Cefaleas Secundarias/etiología , Seudotumor Cerebral/complicaciones , Trastornos Puerperales/etiología , Acetazolamida/uso terapéutico , Adulto , Venas Cerebrales/patología , Dieta Hiposódica/métodos , Diuréticos/uso terapéutico , Femenino , Humanos , Imagen por Resonancia Magnética , Flebografía , Seudotumor Cerebral/diagnóstico , Seudotumor Cerebral/terapia , Trastornos Puerperales/diagnóstico , Trastornos Puerperales/terapia , Punción Espinal

RESUMEN

A hydatidiform mole with a coexisting live fetus is a rare occurrence and the optimal management for this condition is not yet known. We report the case of a 32-year-old woman (gravida 3, para 2) who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in March 2012 at 13 gestational weeks with abdominal pain and vaginal bleeding. An ultrasound examination revealed a hydatidiform mole pregnancy coexisting with a live fetus. After extensive counselling, the patient and her husband opted for a conservative management approach. Unfortunately, a hysterotomy had to be performed at 17 gestational weeks due to severe haemorrhage. The postoperative period was uneventful and histopathology results confirmed one complete mole with a coexisting fetus and normal placenta. The patient's serum ß-human chorionic gonadotropin level remained normal for 18 months following her surgery.