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Re: A case of preeclampsiaFrom: Malcolm Griffiths (malcolm@mgriff22.demon.co.uk)Fri Jan 31 16:26:16 1997
In message <199701302252.WAA48911@cariari.ucr.ac.cr>, Sing-Hung Chang <changl@cariari.ucr.ac.cr> writes >At this point, what should be the next step in her management? Give steroids. Even if you end up delivering her in less than 24 hours there's some gain and no loss. > How soon >should the pregnancy be resolved?
Soon - there's no prospect here of prolonging the pregnancy for more
than a few days. This would help steroids to work, but there's no rela
chance of gain beyond first 24 hours.
> Is it wise to observe her, wait upon lab
I'd get the labs. You will need these anyway even if you decide to
deliver more or less straight away.
>And how about I'd give intermittent bolus therapy with either hydrallazine or nifedepine whenever BP goes up. I'd definitely deliver her once the steroids were on board and sooner if any of the indices of severitiy ( lab tests, proteinuria or urine output ) went the wrong way. Finally I'd have asked her what she thought/wanted ! What happened to the last child ? Ultimately VERY low threshold for delivery. Later I'd want to look for predisposing factors ! Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp., LU6 2DT, UK. Tel: 01582-497459 (office) Fax: 01582-497424 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "It is dangerous to be right on a subject on which the established authorities are wrong." (Voltaire) "But sometimes it's fun :-)" (Griffiths)
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