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Re: OB: Fun with preeclampsia--very long!From: Luis Sanchez-Ramos, MD (luis.sanchez@jax.ufl.edu)Sat Jul 28 09:29:17 2001
At Sat, 28 Jul 2001, Myer Bornstein wrote: >>Attached is a portion of a power point presentation re Diagnosis of Preeclampsia, given by Dr John Repke at the Annual Jewett Lecture present by the Mass Med Society and the Committee on Maternal and Perinatal Welfare. It lists the accepted criteria for Preeclampsia<< Dr. Bob Woollley in an earlier post cites the most acceptable reference with regard to the diagnostic criteria for preeeclampsia. Basically, a patient has to have HYPERTENSION(BP 140 or greater of 90 mmHg or greater taken twice)in addition, she needs to have either proteinuria or edema 9hands & face). This latter criteria is gradually being phased out. Similarly, the diagnosis of hypertension based on a 30 mmHg increase in systolic or 15 mmHg increase in diastolic blood pressure from baseline values is also being discouraged. By now, the diagnosis should be clear. Garry and his partners need to tell us what the blood pressure readings were during labor and postpartum as well as follow-up lab values (platelet counts, uric acid, sgot, ast, urinary dipsticks). I hate to to disagree with Dr. Cutchin, but a drop in platelets from 100K to 20K without any evidence of hypertension does not lead to a diagnosis of preeclampsia. One certainly has to rule it out, but unless the patient has hypertension, she does not have preeclampsia (at least that can be diagnosed clinically). LSR
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