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Re: What would you do, new case From: dahmd@gate.net Fri Jan 3 16:30:39 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Myer S. Bornstein: "Re: What would you do, new case" Previous message: Robert J Woolley: "Re: Evidence & Economics" Maybe in reply to: Garry E. Siegel: "What would you do, new case" Next in thread: Geffrey H. Klein, MD: "Re: What would you do, new case" Reply: Geffrey H. Klein, MD: "Re: What would you do, new case" In article Robert J Woolley <wooll005@gold.tc.umn.edu> writes: >On Fri, 3 Jan 1997, Garry E. Siegel wrote: >> Upon return at 38 weeks, she remains symptom free, gained 1 pound, has 1 + >> voided protein (no other positives on dipstick), and has a BP of 138/94, >> repeated 140/85. >I'm willing to guess that I'll be the exception here, but I would not >place any diagnosis on this. I would start seeing her more frequently >(twice weekly), and react if the bp went up more or the protein became >2+, or even if she developed a true generalized edema (not just wt gain). >But for now, heightened scrutiny, but no definitive intervention. All other things being equal, I agree with you. Why not place her on her side at home, check a 24-hour urine for protein, and see her frequently? I would also give her instructions on when to come in, day or night (i.e. spots in front of eyes, severe headache, epigastric pain, etc). I don't see any diagnosis yet, although she may or may not develop preeclampsia. I would *not* prescribe antihypertensives or worry about a salt-free diet, and I would not induce her (until you have an indication). Some might say to put her in the hospital for observation, and depending on the patient and on the situation that would be acceptable. Don't pull a Geff on us:) Tell us what happens! Ashley D. Ashley Hill, M.D. dahmd@gate.net Orlando, FL Next message: Myer S. Bornstein: "Re: What would you do, new case" Previous message: Robert J Woolley: "Re: Evidence & Economics" Maybe in reply to: Garry E. Siegel: "What would you do, new case" Next in thread: Geffrey H. Klein, MD: "Re: What would you do, new case" Reply: Geffrey H. Klein, MD: "Re: What would you do, new case"

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