What would you do, new case

From: Garry E. Siegel (garrys@atl.mindspring.com)
Fri Jan 10 16:18:42 1997

*******the answer follows, followed by the original posting****************

Thanks for all the advice. I have followed this woman biweekly with a stable BP of 140/90, no symptoms, 1+ protein, stable weight, etc. Today, at 39 5/7, her cervix is 1.5 cm (fingertip)/50%/-2/soft/mid. I plan to place PGE2 supps, 4 mg. (these are great, BTW) on Sunday, 1/12, and induce Monday, 1/13 at 40 1/7 weeks. Baseline lab is to be repeated on admission.

Assuming the BP is stable, and labs normal, what do ya'll think about seizure prophylaxis? Is in necessary? If so, what agent do you use and how do you give it?

Garry

I'm interested in how different physicians would handle a case as described >below:
>
>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.
>
>The clinical EFW is 3600g, and her cervix is 0/25%/posterior/firm/-3. She
>is vertex.
>
>BTW, her dates are rock solid, if that matters.
>
>Diagnosis, if any?
>
>Treatment options, if needed?
>
>This seems straightforward, but I can't remember this thread being kicked
>around other than Geff's recent weirdo case.
>
>Garry E. Siegel, M.D.
>Roswell, Ga.
>
>PS--I had a large lunchtime gap in the office today, the first since the
>holidays; what a pleasure to do the email during the day instead of working.
>

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