-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Postpartum eclampsia From: Dr. Rupak Ranjan Roy (rupakroy@vsnl.com) Tue Aug 19 12:38:22 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Postpartum eclampsia" Previous message: Gerald P. Rodríguez: "Re: HUMOR: Show & Tell" Maybe in reply to: Dr. Ainsworth: "Postpartum eclampsia" Next in thread: Efrain Ramirez: "Re: Postpartum eclampsia" Now this is a strange coincidence. I had a patient just two weeks ago who had repeated seizures 10 days after delivery (she was delivered by a different obstetrician). No real problem with BP either during pregnancy or post partum. Though close questioning did reveal a BP of 140/90, but certainly no more. Ten days later, she had severe headache and confusion and the blood pressure apparently shot up to 200/120. She had some treatment at home by her doctor (not sure what) and 24 hours later started having recurrent fits and was brought to our hospital. She was put on mag sulph and IV antihypertensives. CT scan was normal. No proteinuria. Prompt response to treatment and discharged home after a week. Seen by the cardiologist and the neurologist - could not find any other explanation for her fits. I saw her yesterday and she is fine. Now she is on nifedipine and methyl dopa and her BP is very well controlled. I found out a paper in the American journal where, as far as I can remember 26 out of 29 postpartum eclamptics had their fits >48 hours after delivery, one had a fit after 2 weeks. Dr. Rupak Ranjan Roy MRCOG >----- Original Message ----- From: "Dr. Ainsworth" <ainsron@sbcglobal.net> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net> Sent: Tuesday, August 19, 2003 11:22 AM Subject: Postpartum eclampsia > I saw a patient recently who was 6d postpartum, delivered by a CNM whose > backup physician was not available. During her pregnancy, delivery and > postpartum, her BP had been normal until 4d postpartum, when she had a > slight increase in BP, noted on home monitoring. She was started on > Labetolol, 100 mg QD and two days later presented to the ER with a > "worst headache ever". In the ER she was noted to have a severe > hypertensive crisis, BP 200/150, some mental status changes, but no > seizure. The chem panel and platelet count were normal except for low > albumin, she was not spilling any albumin in her urine, BP responded to > catapres, she was placed on MgSO4 and stabilized and then I started her > on Labetolol, 200 mg BID. CT scan was normal. The reason she was being > watched closely was because during her last pregnancy she had eclampsia > at 8d postpartum. Between pregnancies she was completely normotensive. > Any thoughts on etiology? I suggested to the other physician that she > should be checked for an adrenal tumor. > Next message: Efrain Ramirez: "Re: Postpartum eclampsia" Previous message: Gerald P. Rodríguez: "Re: HUMOR: Show & Tell" Maybe in reply to: Dr. Ainsworth: "Postpartum eclampsia" Next in thread: Efrain Ramirez: "Re: Postpartum eclampsia"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Fri May 2 04:37:13 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.