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Re: Another case from Malcolm From: Malcolm Griffiths (malcolm@mgriff22.demon.co.uk) Thu Jul 3 17:30:55 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Samir Saidi: "Re: Another case from Malcolm" Previous message: Terry J. DuBose: "Re: Placental grading" In reply to: Laifer, Dr. Steven: "Re: Another case from Malcolm" In message <33BC0FB1@msmailgw.bpthosp.chime.org>, "Laifer, Dr. Steven" <pslaif@bpthosp.chime.org> writes >With the [limited] clinical and laboratory info you've provided, I would >suspect acute viral hepatitis (A; she is HepBSAg negative). She is negative for: EB ( by Monospot ) Hep A ( IgG & M ) Hep B ( IgG & M ) to sAg Hep C ( IgG & M ) Hep E ( IgG & M ) > Other helpful >info might be exposures, She works as a care asssistant with disturbed adolescents. Her husband is afro-caribean and is a psychiatric nurse. She was due to be vaccianted against Hep-B, but delayed it when she discovered she was pregnant. > ingestion of shell fish, Luton is about as far away from the coast as it's possible to be in the UK. Shellfish ingestion si very upper middle class ( which she ain't ! ) > ?drug or toxin exposure, No ! >occupation, See above under exposures ! > blood pressure, Normotensive > Hgb, platelets. Within normal range > If she has acute viral >hepatitis, I would be reluctant to deliver her in the acute setting unless >there is evidence of fetal compromise. Interested to know why you say that ? Presumably at this gestation there are risks of fetus of pyrexia, viraemia, etc. There are obvious maternal risks, but only if labaoratory tests are sinister. Delivery by CS may be preferable to vaginal for some viruses in terms of vertical transmission. At this gestation ( and having given her already three doses of PG-E2 - possibly inappropriately ) delaying delivery for a few weeks to allow her to recover completely doesn't seem like a tenable option ! You wer quite close - any other suggestions ??? > >Happy Fourth to Listmembers; Is this referring to something by Bruce Springsteen ? > with respectful consideration to our >colleagues in the UK. Any consideration from NEW ENGLAND gratefully received ! Best wishes to those in the ( former ) colonies ! Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp., LU6 2DT, UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "It is dangerous to be right on a subject on which the established authorities are wrong." (Voltaire) "But sometimes it's fun :-)" (Griffiths) Next message: Samir Saidi: "Re: Another case from Malcolm" Previous message: Terry J. DuBose: "Re: Placental grading" In reply to: Laifer, Dr. Steven: "Re: Another case from Malcolm"

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