Reversible posterior leukoencephalopathy syndrome due to eclampsia in a woman with a twin pregnancy produced with donated oocytes.

A 35-year-old primigravida with severe ovarian dysfunction underwent in vitro fertilization with oocytes donated by her sister. A twin pregnancy ensued, and she received prenatal care at our hospital. She underwent a cesarean section at 35 weeks' gestation because of pregnancy-induced hypertension (PIH) and breech presentation at the onset of labor. Eclampsia with a generalized seizure occurred 5 hours after the cesarean section, while the patient was receiving medical treatment for disseminated intravascular coagulation secondary to an atonic uterus. Reversible posterior leukoencephalopathy syndrome (RPLS) was diagnosed with magnetic resonance imaging the following day. With control of the hypertension and seizures, the condition of the patient was stabilized, and the RPLS resolved several days later. Eclampsia and RPLS associated with pregnancy can be life-threatening and are typically closely related to PIH. Thus, this case illustrates that the risk of PIH is increased in pregnancies produced with donated oocytes.