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Re: What would you do, new caseFrom: Myer S. Bornstein (mborn@massmed.org)Fri Jan 3 17:08:51 1997
>> 30 YO nulligravida with an uncomplicated pregnancy presents for routine >> visit at 37 weeks. Her blood pressure (taken by the nurse, sitting) is >> 120/80, no proteinuria, and a 5 pound weight gain in 2 weeks. Her baseline >> BPs since 8 weeks, and in prior gyn visits, are 100 to 110/60 to 70. >> >> 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. I agree with Bob, I would see her at least 2x/week, do a 24 hr urine for protein and creatinine clearance. check her HH, Platlets, and a chem panel. If BP kept increaseing along with other signs/symptoms of PIH think of hospilization and delivery. Myer
-- Myer S. Bornstein, M.D. FACOG Chairman Department of Obsterics and Gyneclogy Morton Hospital and Medical Center Taunton, MA
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