Pregnancy with Preeclampsia and Bell's Palsy: An Interesting Case

ABSTRACT

Aim

To describe a case of pregnancy with Bell's palsy in a preeclamptic woman

Background

Preeclampsia is a common obstetric morbidity, which has been studied extensively, of which neurological problems are also well known. Facial nerve palsy is usually attributed to herpetic lesions or is autoimmune in nature. An interesting case of pregnancy with Bell's palsy in a preeclamptic woman is described here.

Case description

A 20-year-old primigravida with 36 weeks gestational period, was referred to our tertiary care center in view of raised blood pressure. She had a history of cold and fever around 1½ months prior to this presentation, following which she developed weakness over left side of the face. The immediate reason for referral was the elevation of blood pressure to 150/100 mm Hg, development of proteinuria (+2 on dipstick), and ultrasound report that showed intrauterine growth restriction. She had received an injection of betamethasone 12 mg intramuscular prior to referral. Her neurological examination showed left-sided facial deviation, left-sided ptosis. In addition, tablet labetalol 100 mg twice a day was initiated. The ultrasound report showed fetal growth with an estimated fetal weight of 2260 g, amniotic fluid index of 6.7 cm, grade III maturity of placenta, and reduced cerebroplacental ratio (1.06). After the induction of labor, due to intrapartum monitoring showing fetal heart decelerations, an emergency lower segment cesarean section was performed.

Conclusion

Though Bell's palsy is commonly reported to occur in the background of chronic hypertension and obesity, it can occur in an otherwise low-risk patient. Occurrence of Bell's palsy may be the precursor toward the development of a preeclamptic state.

Clinical significance

Occurrence of Bell's palsy should raise the obstetrician's level of vigilance towards maternal/fetal surveillance.

How to cite this article

Reddy AK, Prasad M, Datti S, et al. Pregnancy with Preeclampsia and Bell's Palsy: An Interesting Case. J South Asian Feder Obst Gynae 2023;15(3):359–361.