Re: Prolonged PP fever + FRI: Pluto

From: Betsy Hyde (elishyde@mindspring.com)
Fri Aug 25 22:03:56 2006


On Aug 25, 2006, at 8:44 PM, Terrence.Jones@kp.org wrote: >
> Pre-E is our Residents' abbreviation for preeclampsia.

ah. here they are now talking PEC. Took awhile for that abbreviation to become known, as well...esp when the verbal was "she has PECK" huh?|

> (Think of all the syllables saved at the end of a single day!) Did
> She have any bp elevation? Any chance the placenta might have been
> sent? Guess I already know the answer...

we are pretty good about sending placenta to path. I just don't know about this case.....my involvement started on PP rounding when she had been febrile for a while. I do not think she had bp elevation/lab abnormalities c/w preeclampsia, though.

> Was enlightening to see, in the Mercer series, that Pre-E was 3-4X
> more prevalent than chorio, in SPT. Demonstrates that inflammation
> is not always infectious.
>
> Guess You get enough local exposure to the anti-
> thromboembolic mechanisms involved (Paidas, Semin Perinatol 2005,
> 29:150-63). But also think it's interesting that attn is turning to
> immune modulating effects of Heparin (Salmon, Nat Med 11/2004,
> 10:1222-26). /tj

Yes, Mike Paidas is here at Yale, but long, long, long before I was a midwife, I did blood coagulation/VTE research. Published in 1973 that eclampsia showed more evidence of intravascular coagulation (based on fibrinogen/fibrin degradation products) than did preeclampsia than did normal pregnancy than did nonpregnant controls (except those on combination OCPs). Not a new concept!!

--
Betsy Hyde CNM
Branford, CT




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