|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: 36 weeks and creat increasingFrom: Robert Brenner (robbrenner@earthlink.net)Sat Mar 30 09:12:22 1996
At 06:55 PM 3/28/96 -0600, you wrote: >30 yo G2P1 familiy practice patient at 36 weeks gestation by good dates and >early ultrasound. First pregnancy uncomplicated. At bedrest over past 2 >weeks for slightly elevated BP's 130's over low 90's. No proteinuria. No >headache. Normal urine output. No swelling. NST reactive. Ultrasound >appropriate size with normal AFI and BPP 8/8. Labs 2 weeks ago normal with >creatinine of 0.8. Labs repeated today with creat 1.3. Platelets 145K. > SGOT 42. Cervix 2/50 and 0 station. Referred for "induction". >I prefer to repeat creatinine and get 24 hour urine for creatinine clearance. > Anybody wanting to deliver at 36 weeks based solely on DBP in the 90's and >an elevated creatinine? >Interested in others management plans. What to do if the creat clearance is >low? >Thanks >Mitch Nudelman I don't see any reason to deliver this patient now. Personally, I never would have gotten a creatinine on this patient to begin with. If the creatinine clearance is low, I would tap at 37 weeks and deliver when lungs are mature. Also, the case as presented makes no sense. If a dropping creatinine clearance is indicative of diminishing renal function, then there must be an etiology. Without a diagnosis of preeclampsia and no other signs of renal disease such as proteinuria or hematuria, I would have to assume that the lowered creatinine is a fluke.
-- Robert Brenner MD Robbrenner@earthlink.net
|
|
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 05:17:49 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.