Re: Dr. Siegel re: pre eclamptic patient

From: Efrain Ramirez (eramirezt@coqui.net)
Sat Mar 10 12:16:00 2007


It is not just BP.. a bit more complicated -and I know you know that... the names of "severe" and "mild" may alter your judgement in management if you don't see the patient as a whole..

I don't really care if "moderate" doesn’t exist .. is the fetus/mother better off continuing with the pregnancy or not?

Ef

CLINICAL MANAGEMENT GUIDELINES FOR OBSTETRICIAN—GYNECOLOGISTS NUMBER 33, JANUARY 2002

Diagnosis of Severe Preeclampsia Preeclampsia is considered severe if one or more of the following criteria is present:

Blood pressure of 160 mm Hg systolic or higher or 110 mm Hg diastolic or higher on two occasions at least 6 hours apart while the patient is on bed rest

Proteinuria of 5 g or higher in a 24-hour urine specimen or 3+ or greater on two random urine samples collected at least 4 hours apart

Oliguria of less than 500 mL in 24 hours

Cerebral or visual disturbances

Pulmonary edema or cyanosis

Epigastric or right upper-quadrant pain

Impaired liver function

Thrombocytopenia

Fetal growth restriction

This Practice Bulletin was developed by the ACOG Committee on Practice Bulletins — Obstetrics with the assistance of Larry C. Gilstrap III, MD, and Susan M. Ramin, MD. The information is designed to aid practitioners in making decisions about appropriate obstetric and gynecologic care. These guidelines should not be construed as dictating an exclusive course of treatment or procedure. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institution or type of practice.

At Sat, 10 Mar 2007, R. Daniel Braun wrote: >
>The BP criteria is 160/110 sustained. Forget the Book, go to the ACOG
>Practice Guideline.
>
>Dan
>
>On 3/10/07, DoctorJoe@aol.com <DoctorJoe@aol.com> wrote:
>>
>> In a message dated 3/9/07 8:00:01 PM, rd.braun@gmail.com writes:
>>
>> by the criteria published, it is.
>> At 28 weeks it is.
>> At 34 weeks, No way.
>>
>> Anyone got a current Williams on hand? What's the "book definition" of
>> "severe" preeclampsia?
>>
>> Joe P.
>>
>> "Chuck Norris says 'hi'. That only means his roundhouse kick is aimed at
>> your head."
>>

>> from AOL at http://www.aol.com.
>
>--
>R. Daniel Braun, MD FACOG(L) CMT
>Professor Emeritus
>Dept. of Obstetrics and Gynecology
>Indiana U. School of Medicine
>
>R. Daniel Braun
>
> "The way to health is an aromatic bath and scented massage everyday".
> Hippocrates
>

--
“ The greatest obstacle to knowledge is not ignorance,
it is the illusion of knowledge.” Daniel J. Boorstin - Historian




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