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Richard Chudacoff, MD
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-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew
Folley
Sent: Thursday, October 06, 2005 8:28 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: OB: Severe Pre-eclampsia
Severe Preeclampsia. Keep in house and on MgSO4. Monitor mom and baby
closely. Follow platelets,watch LFTs, fetal dopplers. Watch urinie output
and creatinine level. Follow 24hr creatinine clearance Induce if mom or baby
deteriorate. Use cervidil ripening then Pitiocin with Mg. Otherwise induce
at 36 weeks. andrew
>From: garrys@mindspring.com (Garry E. Siegel, M.D.)
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: OB: Severe Pre-eclampsia
>Date: Wed, 5 Oct 2005 17:15:35 -0500
>
>36 YO P1001 admitted at 34w2d with 150/90, 2+ protein, no symptoms,
>normal SGOT, platelets, and creatinine of 0.7.
>
>24 hour protein 2.6 grams while in house.
>
>Next 24 hour urine begun.
>
>Our MFMs generally say don't deliver for severe disease if only for
>proteinuria, but generally that seems to be for the under 32-weekers.
>Usually, by the time they are severe by proteinuria, something else
>declares itself such that delivery is necessary.
>
>The next urine came back at 34w6d at 6.2 grams; other labs normal. Her
>cervix is long/closed, and she's delivered vaginally before at term
>without PIH. The MFM scan is normal with normal dopplers, 8/8 BPP and
>OK growth.
>
>What would you do?
>If you choose to induce, would you use Magnesium Sulfate?
>
>Garry
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
