post partum eclampsia

[GiJoe]

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so did i jump the gun here? i have this 17 yo female post partum about 2 weeks. had pre eclampsia issues during her pregnancy, who came in c/o headache, vision problems dizziness and had a bp 140-150 systolic. i was thinking post partum eclampsia was right around the corner so i gave her 2 grams of mag (pretty harmless) and called ob. the ob resident started to bitch about how mag should only be given during pregnancy for the benefit of the fetus and it didnt make sense to give it to someone who is 2 weeks post partum.

am i missing something here or does she need to see her psychiatrist?

 

[deleted109597]

OB is wrong. Mag isn't given to benefit only fetus. It also breaks seizures. You didn't hurt the patient any, so don't worry.

 

[Arcan57]

We've had a rash of post-partum ecclampsia, and Mg did good things especially for the patient with intractable seizure.

 

[ZigZag]

I had almost identical situation once.
The reason why they are bitching is that now they have no choice but to admit the patient. I personally don't think twice about it.

 

[BADMD]

so did i jump the gun here? i have this 17 yo female post partum about 2 weeks. had pre eclampsia issues during her pregnancy, who came in c/o headache, vision problems dizziness and had a bp 140-150 systolic. i was thinking post partum eclampsia was right around the corner so i gave her 2 grams of mag (pretty harmless) and called ob. the ob resident started to bitch about how mag should only be given during pregnancy for the benefit of the fetus and it didnt make sense to give it to someone who is 2 weeks post partum.

am i missing something here or does she need to see her psychiatrist?

I'd say you didn't give enough mag. We usually do a 6 gram load then 2 gm/hr.

I guess it is for the benefit of the fetus: A mom that isn't hypoxic and acidotic is probably good for the fetus (and a baby for that matter).

 

[DrQuinn]

Nope. OB is bitching because they have to do work. Happens.

INterestingly, I have had TWO cases of post partum cardiomyopathy in the past two weeks. Never saw it once during residency. Weird. Both with mod-low EFs with BNPs > 500.

Q

 

[Painter1]

As a resident, i hated dealing with the ob-gyn residents. In my experience, they are particularly lazy and nasty. That combo always made for a tumoultous interaction whenever i called them.

 

[dchristismi]

I think it's catching... I saw a postpartum pre-E case yesterday! It could have just been a migraine, but her BP was up. No urine protein, but bumped her LFTs a bit. I called her private OB, and before I could say much else, she said she wanted the pt transferred to our OB hospital and she would be calling the charge nurse with admitting orders, and would meet the patient there.

And BAM, that's how it works attending-to-attending.

 

[Jeff698]

And BAM, that's how it works attending-to-attending.

Sweet.

Take care,
Jeff

 

[Jeff698]

And BAM, that's how it works attending-to-attending.

Sweet.

Take care,
Jeff