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Re: OB: Fun with preeclampsia--very long! From: Paul Prior MD (pprior@clover.net) Fri Jul 27 08:59:30 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Paul Prior MD: "Re: Fainting episode patient - differential diagnosis today" Previous message: DMECNM@aol.com: "Re: Off Topic, But Brings Back Memories For Me -- Frances R. Horwich, 94, Hos..." In reply to: Robert Woolley: "Re: OB: Fun with preeclampsia--very long!" Next in thread: Robert Woolley: "Re: OB: Fun with preeclampsia--very long!" Reply: Robert Woolley: "Re: OB: Fun with preeclampsia--very long!" Reply: Garry Siegel: "Re: OB: Fun with preeclampsia--very long!" On Thu, 26 Jul 2001 23:05:26 -0500, Robert Woolley <wooll005@tc.umn.edu> wrote: > >> 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? Bob, severe pre-eclampsia can certainly occur in the absence of proteinuria. Been there, done that. Variant of HELLP basically. Having said that, I am interested to see that someone diagnosed with "severe" preeclampsia was managed over a 3 day period. My goal is to get those patients delivered within 24 hours of diagnosis. I understand that this was somewhat of a "soft" call, but once the diagnosis is on the chart.... Was a foley bulb considered? I have found that an excellent adjunct to cytotec, when there are too many contractions to give a 2nd dose. >> 11 AM: Deliveries healthy baby vaginally by partner. Asks partner why >> she has to stay on mag for 24 hours! LOL, I think this patient has seen all of us in the past :) -- Paul Prior MD They that can give up essential liberty to obtain a little Coshocton, OH temporary safety deserve neither liberty nor safety. Solo Practice - Benjamin Franklin, 1759. OB/GYN, FACOG Next message: Paul Prior MD: "Re: Fainting episode patient - differential diagnosis today" Previous message: DMECNM@aol.com: "Re: Off Topic, But Brings Back Memories For Me -- Frances R. Horwich, 94, Hos..." In reply to: Robert Woolley: "Re: OB: Fun with preeclampsia--very long!" Next in thread: Robert Woolley: "Re: OB: Fun with preeclampsia--very long!" Reply: Robert Woolley: "Re: OB: Fun with preeclampsia--very long!" Reply: Garry Siegel: "Re: OB: Fun with preeclampsia--very long!"

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