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Re: ? HELLP Syndrome From: james connerth (babydoc@apex.net) Wed Jul 5 11:51:22 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. Lynn Montgomery: "Re: Floating Villi {:<(" Previous message: Braun, R. Daniel: "Re: ? HELLP Syndrome" Maybe in reply to: Dr. Lynn Montgomery: "? HELLP Syndrome" Next in thread: Eberhard W Lisse: "Re: ? HELLP Syndrome" Agree with d/c mag and KEEP in hosp-karyotype great --is this "mirror syndrome"-may be seen with aneuploidy /severe RH-hydrops--mom looks like baby-SICK??? DoctorJoe@aol.com wrote: > In a message dated 7/5/0 10:00:17 AM, you wrote: > > <<All right, I really need help on this one y'all. > > 28 yo presents at 21.5 weeks with severe headache, epigastric pain and mild > shortness of breath. Found to have elevated liver function tests, 25 pound > weight gain in 3 days. Coags, urine protein, renal function, cardiac echo, > uric acid, TSH, autoimmune and antiphospholipid work-up all normal. > Ultrasound shows viable AGA fetus, no evidence of molar element > > Hospitalized and started on mag sulfate. Over the course of the next week, > the edema resolved and the liver function returned to normal and has remained > such. The patient feels great except residual pain from the markedly severe > pedal edema she had. Fetus continues to look good. > > Now what to do: > > -Stop the mag and send her home? > > -Keep her on the mag, in the hospital and wait for the hammer to drop>> > > Would wonder about a quick karyotype... STILL worried about triploidy, since > his is WAY early for preeclampsia in its usual presentation. Maybe a CVS > (which CAN be done on a "mature" placenta, right? Esp. if you're looking a > chromosome numbers, rather than weird deletions etc.. which take more time.) > > It's fairly characteristic that in preeclampsia, bed rest will TEMPORARILY > make the syndrome get "better," but it always returns. I'd be scared to let > her go home like this, especially with the epigastric pain and elevated liver > functions. If she goes home, she could come back with seizures and/or > ruptured liver. So I'd vote to keep her so the hammer can drop in the > hospital under observation. > > Joe P. Next message: Dr. Lynn Montgomery: "Re: Floating Villi {:<(" Previous message: Braun, R. Daniel: "Re: ? HELLP Syndrome" Maybe in reply to: Dr. Lynn Montgomery: "? HELLP Syndrome" Next in thread: Eberhard W Lisse: "Re: ? HELLP Syndrome"

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