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Re: Clinical case From: A. C. Cunha (kimle@mithlond.esoterica.pt) Mon Mar 24 19:50:53 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Harvey S. Marchbein, M.D.: "Re: Postmenopausal bleeding" Previous message: Myer S. Bornstein: "Re: Clinical case" Maybe in reply to: RICARDO FRANCALACCI SAVARIS: "Clinical case" Next in thread: rbraun@indyunix.iupui.edu: "Re: Clinical case" > Date: Mon, 24 Mar 1997 10:06:56 -0600 > Reply-to: ob-gyn-l@obgyn.net > From: "RICARDO FRANCALACCI SAVARIS" <savaris@orion.ufrgs.br> > Female, 34 yo, black, G7P6, 40 wks, arrives on the Delivery Ward at 7:30 am > with BP of 210/140, headache, vaginal bleeding, epigastric pain. > Started with Hydralazine, Mg++ sulphate Are you using maintenance terapy? Per os? Wich dose? > and in 10 minutes had a normal > delivery of a baby with thick meconium, APGAR 5/6 Was he a small for dates baby? Was this a fast or a slow labor? Was she hipertensive before pregnancy? > At 11:30 am, another hypertensive peak 170/120, Started with Nifedipine SL, > alpha-methildopa 500 mg tid. BP controlled > At 2:00 pm she started to be agitated and to complain about epigastric and > upper right quadrant pain. Acute, sharp, non irradiated, no colic like, no > burnig, never experienced this pain before. Abdominal palpation: Tenderness > on the epigastric and upper right region, no rebound reflex. Bowel > movements diminished. Pelvic exam normal. BP 170/100 PR: 72 bpm > I would think of eminent eclampsia > I asked for FBC, SGOT, SGPT, Amylase, Platelets, Creatinine and started > with pethidine 30 mg IV. No effect for pain relief. Another 30 mg IV, no > effect. > > One hour later: > FBC: Hb: 12.3 Leukocytes: 21,600 with shift to the left Platelets 336,000 > Amylase, SGPT, Creatinine: normal > SGOT: slightly elevated 54 (n <42) What about her water balance? These lab results can mean some hemoconcentration. Let us know how things develope. Ana C. Cunha, M.D Maternidade Julio Dinis Porto - Portugal Next message: Harvey S. Marchbein, M.D.: "Re: Postmenopausal bleeding" Previous message: Myer S. Bornstein: "Re: Clinical case" Maybe in reply to: RICARDO FRANCALACCI SAVARIS: "Clinical case" Next in thread: rbraun@indyunix.iupui.edu: "Re: Clinical case"

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