Re: prolonged PP fever

From: Betsy Hyde (elishyde@mindspring.com)
Fri Aug 25 17:00:18 2006


On Aug 25, 2006, at 5:39 PM, Terrence.Jones@kp.org wrote:

>
> These regional differences are always interesting. After
> the description per Mercer & Sibai (JMFM 1996, 5:355-8), and the
> comparitive trial per Cunningham (AJOG 1999, 181:143-8), Our MFM's
> actually discourage heparin, in absence of thrombus on imaging.

The heparin was discouraged/delayed because we were told there was no good evidence that it helps if the dx is spt, and that time to defervesence does not vary based on use/nonuse of heparin if there was spt. This, apparently, was from the Cunningham Study.

>
> Drs. Magann & Martin (Hypertens Pregnancy 2004, 23:121-7)
> demonstrated, as You have in this case, that the premorbid state
> does not always include variables associated with infection. Chorio
> was present in only 13% of SPT; in their 9 year series of 55
> postpartum Pts. Instead, the condition may be more of an aberrant
> endothelial response (Pre-E present in 45%). Did Your Patient have
> any stigmata (of Pre-E)?

I don't know what the stimata of Pre-E (or even what Pre-E is....ok, I'll 'fess up) are, and either don't know/can't remember her labor course. Sorry.

\Betsy Hyde CNM Branford, CT





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