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Re: Severe PIH 34 weeks From: rmodugno@aol.com Thu May 24 19:17:36 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Terrence.Jones@kp.org: "Re: Severe PIH 34 weeks" Previous message: Efrain Ramirez: "Re: Delivery suggestions" In reply to: Andrew Folley: "Re: Severe PIH 34 weeks" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Severe PIH 34 weeks" -----Original Message----- From: Andrew Folley <agfolley@hotmail.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Sent: Thu, 24 May 2007 5:55 pm Subject: 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.  -- ################################################### Yo Andy, the hypertension is being "treated" - the underlying process is not. What is your definition of "soon' and why????? (And to answer your "why?" question: abruption, placental insufficiency, IUFD, pulmonary edema,CVA...) As far as making it a neonatal problem, rather than an ob problem - I will ask you - where have been the advances in the treatment of prematurity - with us ob's or the neonatologists? Robert Modugno MD MBA FACOG Sylva,NC   ________________________________________________________________________ AOL now offers free email to everyone. Find out more about what's free ________________________________________________________________________ from AOL at AOL.com. =0 Next message: Terrence.Jones@kp.org: "Re: Severe PIH 34 weeks" Previous message: Efrain Ramirez: "Re: Delivery suggestions" In reply to: Andrew Folley: "Re: Severe PIH 34 weeks" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Severe PIH 34 weeks"

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