|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: atypical eclampsia??From: Len2976@aol.comThu Jun 21 16:31:36 2007
We got this patient as a "walk-in" with no prenatal care last week. 39 y/0 G4, P3003 LMP c/w 33 week IUP initially presented withc/o uterine contractions. After assessment which ruled out labor, she also complained of headaches, nausea, wheezing, and pain in the upper (mid section) abdomen when the baby kicked. B/P 100-136/60-80s; BPP--10/10 EFW 4#, 4 oz Labs: WBC 9.4, Hgb 6.7; U/A small protein; Urine Drug Screen + THC, + amphetamines, + Cocaine Chemistries (including LFTs) all normal; 24 hr. urine-- 350 mg protein. Obstetrician wanted a consults with pulminary medicine and hematology--who ordered 3 units PRBCs. 15 minutes after 1st unit started, patient became very anxious, screaming that her head hurt. B/P was 190/90. The obstetrician was called, blood stopped, Pt. given IV labetolol, MgSO4 started, and neurology consulted. Repeat labs were all normal and shortly after this B/P back down to 130/80. CT scan done=normal. Next morning B/P was 99/60 and obstetrician D/Cd the MgSO4. Repeat labs all normal. After patient given IV benadryl for relaxation, she was transfused without incident. Patient seen by pulmonologist who said she had pneumonia, transferred her upstairs to the medical unit (she had daily NSTs and was seen by OB daily). Two days later, an hour after a B/P of 128/80, patient has a seizure, is transferred to OB--B/P now 130-140s/80-90. Labs still are all normal, and she is sectioned. Baby doing well in the NICU--about 4#--as estimated by U/S. Mother now in ICU with cardiomyopathy. We are all second guessing ourselves knowing that any seizure is eclampsia till proven otherwise. Comments, Please Lenora McCall, CNM ************************************** See what's free at http://www.aol.com. -------------------------------1182461478 Content-Type: text/html; charset="US-ASCII" Content-Transfer-Encoding: quoted-printable <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> We got this patient as a "walk-in" with no prenatal care last week.
39 y/0 G4, P3003 LMP c/w 33 week IUP initially presented withc/o uterine
contractions. After assessment which ruled out labor, she also complained
of headaches, nausea, wheezing, and pain in the upper (mid section) abdomen when
the baby kicked.
B/P 100-136/60-80s; BPP--10/10 EFW 4#, 4 oz
Labs: WBC 9.4, Hgb 6.7; U/A small protein; Urine Drug Screen + THC, +
amphetamines, + Cocaine
Chemistries (including
LFTs) all normal; 24 hr. urine-- 350 mg protein.
Obstetrician wanted a consults with pulminary medicine and hematology--who
ordered 3 units PRBCs. 15 minutes after 1st unit started, patient became
very anxious, screaming that her head hurt. B/P was 190/90. The
obstetrician was called, blood stopped, Pt. given IV labetolol, MgSO4 started,
and neurology consulted. Repeat labs were all normal and shortly after
this B/P back down to 130/80.
CT scan done=normal. Next morning B/P was 99/60 and obstetrician D/Cd
the MgSO4. Repeat labs all normal. After patient given IV benadryl
for relaxation, she was transfused without incident.
Patient seen by pulmonologist who said she had pneumonia, transferred her
upstairs to the medical unit (she had daily NSTs and was seen by OB
daily). Two days later, an hour after a B/P of 128/80, patient has a
seizure, is transferred to OB--B/P now 130-140s/80-90. Labs still are all
normal, and she is sectioned. Baby doing well in the NICU--about 4#--as
estimated by U/S.
Mother now in ICU with cardiomyopathy.
We are all second guessing ourselves knowing that any seizure is eclampsia
till proven otherwise.
Comments, Please
Lenora McCall, CNM See what's free at AOL.com.
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:07:18 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.