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Re: Preeclampsia Lab Package From: Braun, R. Daniel (rbraun@iupui.edu) Sat Jun 27 10:31:35 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: zygote@ICSI.Net: "Re: Preeclampsia Lab Package" Previous message: Greg and Amy Hinson: "misoprostol" Maybe in reply to: Dean Huffman: "Preeclampsia Lab Package" Next in thread: Braun, R. Daniel: "Re: Preeclampsia Lab Package" Then if the platelets come back low, you can order all the other things if you wish. Dan -----Original Message----- From: john.robertson@obgyn.net To: Multiple recipients of list Sent: 6/26/98 11:39 AM Subject: Re: Preeclampsia Lab Package To play devils advocate (spooky movie don't you think?), I have certainly been caught off guard by patients with relatively mild symptoms, and have significant laboratory abnormalities. Certainly the most common one is low platelets, but then the question is - is this an isolated finding (ie ITP etc ) or is this part of pre-eclampsia / help, and yes the differential does have different implications for me. Don't get me wrong, I don't like indiscriminant lab tests, but I have occasionaly gotten a suprise back in my labs. At Fri, 26 Jun 1998, Braun, R. Daniel wrote: > >Why do we persist in obtaining all these useless labs on our patients >who are pre-eclamptic?? Do we really need to get liver functions and >uric acids on the 17 Y/O who presents at 39 weeks with a BP of 140/90 >and 3+ proteinuria?? I propose that all we need is a hemoglobin and a >platelet count. Has anybody ever seen such a patient as described above >who had clinically significant HELLP syndrome without epigastric pain or >low platelets. In fact by definition, she has to have low platelets to >have HELLP syndrome. So why get all these tests that will not change our >management? In the patient described above, we all would start MgSO4 and >induce, regardless of the results of all the tests ergo, why get them?? >If you set up a pre-eclamptic panel, there will be people (& lawyers) >who think that it is required on all pre-eclamptics. > >This is really one of my soap boxes, please don't take offense. >Dan > >> -----Original Message----- >> From: Dean Huffman [SMTP:perinatl@sprynet.com] >> Sent: Friday, June 26, 1998 6:53 AM >> To: Multiple recipients of list >> Subject: Preeclampsia Lab Package >> >> As you know, Medicaid is forcing hospitals to drop lab panels such as >> "Chem20" and to institute specific panels, such as "electrolyte >> panel", etc. >> >> I was wondering... >> >> Does anybody have a "Preeclampsia Panel" of lab work? Such a panel >> might >> have SGOT, SGPT, uric acid, etc. >> >> If anybody has such a lab panel or protocol at their hospital, or if >> anybody >> would like to suggest such a panel, I would appreciate hearing from >> them. >> >> Dean Hhuffman >> perinatl@sprynet.com >> -- J.G.M.Robertson MD, 109-9181 Main St. Chilliwack, B.C. V2P 4M9 (604) 793-9988 e-mail john.robertson@obgyn.net Who is wise and understanding among you? Let him show it by his good life, by deeds done in the humility that comes from wisdom. James 3 vs 13, NIV Next message: zygote@ICSI.Net: "Re: Preeclampsia Lab Package" Previous message: Greg and Amy Hinson: "misoprostol" Maybe in reply to: Dean Huffman: "Preeclampsia Lab Package" Next in thread: Braun, R. Daniel: "Re: Preeclampsia Lab Package"

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