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Re: atypical eclampsia??From: Deborah.Bopp@memorialhealthsystem.comThu Jun 21 17:23:01 2007
How about a PE? Just guessing Deborah Bopp RN, MS Perinatal Clinical Nurse Specialist The Birth Center Memorial Hospital Colorado Springs, Colorado 80919 719-365-5080 deborah.bopp@memoriahealthsystem.com Sent by: ob-gyn-l@obgyn.net To Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> cc 06/21/2007 03:32 PM Subject Re: atypical eclampsia?? Please respond to ob-gyn-l@obgyn.net We got this patient as a "walk-in" with no prenatal care last week. 39 y/0 G4, P3003 LMP c/w 33 week IUP initially presented withc/o uterine contractions. After assessment which ruled out labor, she also complained of headaches, nausea, wheezing, and pain in the upper (mid section) abdomen when the baby kicked. B/P 100-136/60-80s; BPP--10/10 EFW 4#, 4 oz Labs: WBC 9.4, Hgb 6.7; U/A small protein; Urine Drug Screen + THC, + amphetamines, + Cocaine Chemistries (including LFTs) all normal; 24 hr. urine-- 350 mg protein. Obstetrician wanted a consults with pulminary medicine and hematology--who ordered 3 units PRBCs. 15 minutes after 1st unit started, patient became very anxious, screaming that her head hurt. B/P was 190/90. The obstetrician was called, blood stopped, Pt. given IV labetolol, MgSO4 started, and neurology consulted. Repeat labs were all normal and shortly after this B/P back down to 130/80. CT scan done=normal. Next morning B/P was 99/60 and obstetrician D/Cd the MgSO4. Repeat labs all normal. After patient given IV benadryl for relaxation, she was transfused without incident. Patient seen by pulmonologist who said she had pneumonia, transferred her upstairs to the medical unit (she had daily NSTs and was seen by OB daily). Two days later, an hour after a B/P of 128/80, patient has a seizure, is transferred to OB--B/P now 130-140s/80-90. Labs still are all normal, and she is sectioned. Baby doing well in the NICU--about 4#--as estimated by U/S. Mother now in ICU with cardiomyopathy. We are all second guessing ourselves knowing that any seizure is eclampsia till proven otherwise. Comments, Please Lenora McCall, CNM See what's free at AOL.com.
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