Morning Report: 2/6/2015

Definitions

–       Eclampsia : Preeclampsia with seizure

–       HELLP: Hemolysis, Elevated Liver enzymes, Low Platelets

–       5 % of preeclampsia is postpartum

Dx

BP 140/90 + proteinuria (300 mg /day or Pr/Cr ration of >0.3 mg/dl)

Or

BP 140/90 + end organ damage (proteinuria not present)

–       Plt <100,000

–       LFT (AST, ALT >X2)

–       Cr >1.1 or double the baseline

–       Pulmonary edema

–       Visual problem

–       ? severe headache

LDH (marker of hemolysis and to less extend liver injury)

Coag (not useful)

CMP (Bili, Cr, LFT)

UA (proteinuria)

GYN usually ask for :

–       Uric Acid (association with severity , may predict preeclampsia?)

–       FDP , fibrinogen (marker of DIC)

–       Give Mg if severe preeclampsia

–       Consider antihypertensive if BP >150/100

–       Antihypertensive agents generally acceptable for use in breastfeeding include the following: nifedipine XL, labetalol, methyldopa, captopril, and enalapril.