Fulminating pre-eclampsia at approximately 15 weeks gestation: A case report

Abstract

Pre-eclampsia is currently defined as new-onset of hypertension occurring after 20 weeks gestation, with significant proteinuria or maternal end organ dysfunction. The exact pathophysiology remains uncertain however it has been hypothesised that anti-angiogenic factors arising from the developing placenta contribute to its development. This case report describes the presentation of a 37 year old patient clinically presenting with pre-eclampsia at 15 weeks gestation. A literature review revealed 5 previously reported similar cases, indicating the need for better understanding of the pathophysiology and awareness of the condition at early gestations. We explore the possible differential diagnosis of haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura and discuss the reasoning for the definitive diagnosis of fulminating early onset pre-eclampsia.