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Re: A case of preeclampsiaFrom: Michael J. Wolpmann, M.D. (elvis@llano.net)Thu Jan 30 20:35:56 1997
At Thu, 30 Jan 1997, Sing-Hung Chang wrote: > >Dear list, > >I would like to submit a recent case. > >20 yo G2P0100, previous pregnancy ended 2 years ago by c/s at 26 wk for >eclampsia, now with 28 wks (good dates and adequate prenatal care) came to >ER complaining of severe headache and restlessness. BP upon arrival: >190/120 (all the previous BPs registered on her prenatal card were around >100/70). Pt was completely conscious and lucid, but she looked >apprehensive, tremulous. She had limb and facial edema, hyperreflexia >(+++). FH was 26, normal uterine tone, FHR 140, no uterine activity nor >cervical changes. The rest of the physical examination was unremarkable >(including fundoscopy). > >After the first bolus of hydralazine, BP was 200/130, and patient still >very apprehensive. After 2 more boluses of hydralazine and the loading >dose of MgSO4, BP was lowered to 170/110, then 160/100, and even came down >to 140/80. Less headache, but with dizziness and nausea. Still >hyperreflexic. Blood drawn and urine collected for tests. > >At this point, what should be the next step in her management? How soon >should the pregnancy be resolved? Is it wise to observe her, wait upon lab >results, while inducing pulmonary maturity with steroids? And how about >using oral antihypertensive drugs during that lapse? > >I would like to hear different opinions about the proper management on this >case. > >Thanks a lot in advance for your attention and help. > >-- >Sing-Hung Chang, MD >Resident > Curious...what are remainder of labs? LFT's, platelets, etc.? Deliver her yesterday.
-- Michael J. Wolpmann, M.D.
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