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Re: Post-partum deliriumFrom: ATFSOCCER@aol.comThu Nov 6 21:18:12 1997
In a message dated 97-11-06 07:30:35 EST, you write:
<< >P1, delivered vaginally 2 days ago with PPH due to uterine atony, no
blood transfusion given (post-partum Hb of 7.5gm%). Was well after the PPH
was controlled by oxytocin but still tachycardia(strong pulse) and stable BP.
No more PV bleeding. Had low grade fever over the next 48 hours. Was quite
rational though she felt a bit tired. Then suddenly, early this morning ,she
was delirious and not responding to command. Her head was shaking from side
to side ( not seizure), no photophobia. I have never seen anything like this
before.
> I would consider the following in the differential diagnosis: 1. Post partum psychosis consult psychiatry 2. Metabolic or electrolyte imbalance check sugar, Na Ca etc. 3. Intracerebral event from the hemorrhage as in Pituitary necrosis. Consider a cat scan 4. Possibly drug induced as in recreational drugs. Check urine drug toxicity screen 5. Possible petit mal seizure. Would an EEG be of any help. Probably need a neurologic evaluation. 6. Low on my list would be infectious encephalitis or septicemia. Please let us know what you discover. Andy Folley MD
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