Re: low hgb-update
From: art fougner, md (evsono@pipeline.com)
Sun Aug 12 08:32:08 2007
Hopefully, another shoe won't drop in the ensuing weeks.
Art
At Sat, 11 Aug 2007, Babycatchers@aol.com wrote:
>
>I just wanted to thank everyone for their great information.
>
>The patient was induced last Wednesday and she delivered without difficulty.
>Her hgb on admit was 9.1 after all the IV Fe. She was on pit for about 5
>hours and delivered. Her uterus was extremely boggy after delivery, not
>responding to pit and I ended up giving methergine X3 doses, 8 hours apart.
>We had the whole house on stand by for her. The OB (not my normal back up
>OB) went home to mow his grass (another story entirely), but I had a CCU nurse
>in the room with me, crash cart outside the door, methergine/hemabate and 2
>units on the floor ready to go. The ER doc and on call surgeon were ready to
>help and in house. The OR crew had everything pulled for a hyst if we needed
>it and used the call time to restock the OR. My philosophy is to 'ward off
>evil things' by being ready for the worst. Anything less than that is a good
>thing.
>EBL was about 500cc. We ran several H&H and PT/PTTs after delivery- MDs were
>worried about DIC.
>Next morning H&H was 7.6 and 26. She got a couple of more doses of FE before
>she went home.
>Thank God everything went well.
>
>Up here, the high risk center is not real helpful with patients. Someone
>said to call them and get something done. Well, about a year ago ALL of the
>attending OB/GYN staff left the hospital to protest the malpractice and the
>practice situation in this state, so there are very few new recruits at the
>referral center and they are swamped. I can't blame them, but it makes our job
>harder.
>Still no real answer about the reason for the low H&H or the neuro symptoms.
>We did a CT with and without contrast the next day- but it didn't show
>anything. This is the biggest zebra I have seen in a long time. I hope it is a
>long time before another one comes along.
>
>Thanks again for all the great info.
>
>Vicki Smith, CNM, MSN
>West Virginia
>Midwives- changing the world one baby at a time.
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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