Re: Preeclampsia Lab Package

From: Dr Eberhard W Lisse (el@linux.lisse.na)
Sat Jun 27 11:05:55 1998


Dan,

In message <9D916278299FD111A7E100805FA7C2BA011165C6@cheetah.uits.iupui.edu>, "Braun, R. Daniel" writes:

> Do you have any literature to back up your feelings about Uric acid???

I have done a quick medline abstract search. Numerous articles!

I'd like someone with access to Cochrane do the same...

> I ahve found that if it is elevated in a patient with borderline
> findings of toxemia then it helps me make the diagnosis, but even
> that is my own clinical impression and I have no literature to back
> it up.

I work in a community hospital 380 km away from the referral center and without air transport. I can not induce at will and have the neonatologists sort the baby out. Besides that we don't have intensive care facilities in my hospital I *AM* the neonatologist :-)-O.

So if I get a patient with a mild hypertension and all lab work normal I will try to lower her pressure and monitor her. If I get one where the values are slightly up or raising but without signs or symptoms I can perhaps send her down to the national referral hospital early.

> How many of you out there have one patient like the one I described that
> getting this whole panel of tests would make any diference. If that
> patient has markedly abnormal test, I am going to start MgSO4 and induce
> her and if those tests are normal, I am going to start MgSO4 and induce
> her. So what value are the tests if they do not lead to a change in
> management?

I agree, you don't need to treat the lab. But it might make you sleep better if all results are normal, eg she is less likely to go into HELLP.

An obvious pre-ecclamptic of course is induced, of course. If we have Prostagalin that day...

>> That reminds me, why don't we maybe list the prices of these tests?

What do these tests cost?

el





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