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Re: OB: Fun with preeclampsia--very long! From: Robert Woolley (wooll005@tc.umn.edu) Thu Jul 26 23:03:40 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: OB: Fun with preeclampsia--very long!" Previous message: Dean Huffman: "Victory!" In reply to: Garry Siegel: "OB: Fun with preeclampsia--very long!" Next in thread: Paul Prior MD: "Re: OB: Fun with preeclampsia--very long!" Reply: Paul Prior MD: "Re: OB: Fun with preeclampsia--very long!" > From: garrys@mindspring.com (Garry Siegel) > Reply-To: ob-gyn-l@obgyn.net > Date: Thu, 26 Jul 2001 21:50:06 -0500 > To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com> > Subject: OB: Fun with preeclampsia--very long! > > 33 YO P0, infertility patient, now at 38 weeks sees my partner for a > routine visit. > > Day One > 11 AM: BP 120/90, no increased weight or proteinuria, normal edema for a > 38 weeker, but BP up a bit over baseline from early pregnancy. Cervix > 0/25%/firm/high/posterior/rotten. EFW clinically 2500g, vertex. > Sent to L and D for blood, NST, a few BP checks. > > 1 PM: SGOT normal, creatinine 1.1 (elevated for pregnancy), platelets > 95K. Diagnosis of severe preeclampsia by virtue of thrombocytopenia. Well, we've got a problem already. You're diagnosing her with "severe preeclampsia" when you've found that she has no proteinuria. Please explain. What diagnostic criteria do you use? > > 11 AM: Deliveries healthy baby vaginally by partner. Asks partner why > she has to stay on mag for 24 hours! > > Garry OK, so when did you see the proteinuria in order to diagnose preeclampsia, so that you can at least retrospectively justify all those apparently unnecessary interventions? From your description, she never had hypertension and never had proteinuria. Sounds like you put her through a whole truckload of stuff in order to treat...what? Mild thrombocytopenia? When did Cytotec and/or Pit and/or c-section become indicated to treat thrombocytopenia? Next message: DoctorJoe@aol.com: "Re: OB: Fun with preeclampsia--very long!" Previous message: Dean Huffman: "Victory!" In reply to: Garry Siegel: "OB: Fun with preeclampsia--very long!" Next in thread: Paul Prior MD: "Re: OB: Fun with preeclampsia--very long!" Reply: Paul Prior MD: "Re: OB: Fun with preeclampsia--very long!"

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