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Re: Ob: Chronic HypertensionFrom: Andrew Folley (agfolley@hotmail.com)Mon Dec 24 13:31:09 2007
She may have chronic HTN or gestational hypertension. Either way no need to have started her on aldomet. Antihypertensives will not prevent preeclampsia or eclapsia nor improve outcome of baby and beta blockers may be detrimental in terms of causing IUGR. Lab chemistries normal. Assuming that no significant proteinuria is present. Weight based on US places infant in 10% for 39 weeks. Cervix is semifavorable with a Bishop score of "5". Aggessive mangagement is to induce with pitocin and conservative management is to wait until 41 weeks and induce. (Do modified biophysical profile in 40th week.> Date: Fri, 21 Dec 2007 22:04:02 -0600> From: garrys@mindspring.com> To: ob-gyn-l@dns.obgyn.net> Subject: Ob: Chronic Hypertension> > 35 YO P0 at 39w3d, seen by our CNMs primarily> Donor sperm, IUI by choice (female partner)> > No diagnosis ever made of chronic hypertension, but she says that she> runs 140/90, and in prenatal visits since 26 weeks in our practice has> BP's 135 to 150/85 to 90.> > Two weeks ago, placed on Aldoment 250 BID by one partner.> > Today saw once CNM for a routine visit, asymptomatic, but 138/90 and> sent to L and D for NST and blood work (not sure why, but I wasn't> involved in the decision).> > BP 140/90 or so in L and D, NST reactive, EFW 2850g, cervix> 1.5/50/soft/-2/posterior.> > Creatinine 0.6, Platelets 170K, Hematocrit 36, SGOT 34 (upper normal> 33).> > What is your diagnosis?> > What is your plan of action?> > Garry> > --> Garry E. Siegel, M.D.> Private Practice> Roswell, GA
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