Re: 31 week Toxemia
From: art fougner, md (evsono@pipeline.com)
Mon Oct 31 12:48:06 2005
with the info given, i'd go for steroids and then let the patient and/or
fetuses direct further action. there's not enough here to trigger
action. any more labs back as of yet, lft's, uric acid, etc?
art
At Mon, 31 Oct 2005, doctorjoe@aol.com wrote:
>
>Watch her for a day and give steroids, if not massively improved, deliver.
>
>She's obviously "got" preeclampsia. Bedrest will improve it temporarily and then it'll get worse. The best you can do is stall for steroids.
>
>As far as Mg++, that's a toss-up. I don't like Mg++ for patients like this not moving toward delivery.
>
>Joe P.
>
>-----Original Message-----
>From: Andrew Folley <agfolley@hotmail.com>
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Sent: Mon, 31 Oct 2005 11:59:36 -0600
>Subject: Re: 31 week Toxemia
>
>22 YO BF 31week 5 days. Admitted levell !!! hopital with BP 150 over 90s. Twin gestation di/di. 2+ edema, "toxic" appearance. Platelets 168000 and lfts normal coags normal etc. AFIs are 6 and 3 cm respectively. Babies good on Biophysical provfile and normal doppler flows. 24 hour urine shows 3500 mg of protein and cr. clearance 122cc/min. Vertex / transverse cervix 50% closed.
>Mom constipated, slight nausean no headache or visual problems.
>
>Who wants to delever and by what mode? Who wants to wait watch and treat (how) and what is endoint for your taking steps toward delivery??? andrew
>
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art fougner, md
"I knew I was going to take the wrong train, so I left early."
Lawrence Peter Berra
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