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Re: Severe PIH 34 weeks From: Andrew Folley (agfolley@hotmail.com) Thu May 24 16:53:20 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Andrew Folley: "Re: Severe PIH 34 weeks" Previous message: Andrew Folley: "Re: 28 weeks centralization of flow" In reply to: Meisel Richard L.: "Re: Severe PIH 34 weeks" Next in thread: Meisel Richard L.: "Re: Severe PIH 34 weeks" Reply: Meisel Richard L.: "Re: Severe PIH 34 weeks" Reply: rmodugno@aol.com: "Re: Severe PIH 34 weeks" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Severe PIH 34 weeks" No I am not trying to play stump the list although that is helpful in extending our knowledge. I was on call and came in. I have 6 partners and she was one of their patients. Her doctor told me yesterday that He had been watching her BP from early on. As far as I know she was never diagnosed with essentail HTN. I do not know why her BP started shooting up. I assumed it was PIH or exacerbation of underlying essentail htn. No work up has been done for the htn. Acutally I do not think she ever was above 140/90 until second 24 weeks etc. All I am doing is looking for the scientifically supported logic in delivering vs. waiting. If someone were to show me that 90% of the moms with severe PIH at 34 weeks end up havinig a stroke and or the baby dies then I would deliver. As it is I am not hearing any such arguement. All I have heard is "get her delivered". I keep asking why??????????? Richard could you please direct me to the specific article you are referring to by Sabai. He has so many obviously on HTN PIH Preeclampsia etc. thanks andy PS her BP is been stable at 130/70 past 48 hrs with the labetalol and procardia. Unfortunately the 24 hour urine today shows 600 mg protein up from 200 mg on admission. I suspect we will be inducing soon. >From: "Meisel Richard L." <rmeisel@mac.com> >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Re: Severe PIH 34 weeks >Date: Thu, 24 May 2007 12:50:59 -0500 > >Andrew you are playing stump the "list". > >I'll bite... What precipitated this hypertensive crisis in a mild >untreated hypertensive? > >What work up has been done? (ie VMA, Thyroid, renal flow studies, MRI) > >What will change based on your findings? > >What will be gained by prolonging a pregnancy for a week or two where the >the only neonatal outcome difference is some short term morbidities >(possibly none considering Sabai work)? > >Best Wishes R L Meisel > >On May 24, 2007, at 10:00 AM, R. Daniel Braun wrote: > >>That is info that you should have included in the presentation. That >>makes her a patient with essential Hypertension and a medical crisis. >> >>Dan >> > Next message: Andrew Folley: "Re: Severe PIH 34 weeks" Previous message: Andrew Folley: "Re: 28 weeks centralization of flow" In reply to: Meisel Richard L.: "Re: Severe PIH 34 weeks" Next in thread: Meisel Richard L.: "Re: Severe PIH 34 weeks" Reply: Meisel Richard L.: "Re: Severe PIH 34 weeks" Reply: rmodugno@aol.com: "Re: Severe PIH 34 weeks" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Severe PIH 34 weeks"

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