Clinical Case Database / Category: Case Based Discussion

Therapeutic options in the management of pre-eclampsia

Publication details

Kate Duhig BSc (Hons), Andrew Shennan MD FRCOG
Foundation Years Journal, volume 1, issue 7, p.357 (123Doc Education, London, November 2007)

Abstract

A 30 year old woman presented pregnant at 8 weeks gestation. Her booking blood pressure was 110/70 mmHg and her BMI was 21. She had a medical history of insulin dependent diabetes mellitus for 18 years but was otherwise well and on no medication other than insulin. She had no family history of hypertensive disorders in pregnancy. She subsequently developed pre-eclampsia, presenting at 32 weeks gestation with a 10 hour history of severe headache, blurred vision and epigastric pain. She had been vomiting for 6 hours. Examination revealed a blood pressure of 170/95 mmHg and urine dipstick showed protein. Her BM was 7.6. On examination she had marked ankle oedema and right upper quadrant tenderness. Blood tests showed ALP and ALT were markedly raised.

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Authors

Kate Duhig BSc (Hons) (Corresponding author)

Research Assistant
King’s College London
St Thomas’ Hospital
Lambeth Palace Road
London
SE1 7EH

Andrew Shennan MD FRCOG

Professor of Obstetrics
King’s College London
St Thomas’ Hospital

References

1.  Lewis G, Drife J, Botting B, et al. Why mothers die. Report on confiential enquiries into maternal deaths in the United Kingdom 2000-2002. Department of Health, Welsh Offie, Scottish Offie Department of Health and Department of Social Services. RCOG Press, 2004.

2.  WHO. Make every mother and child count. World Health Report, 2005. Geneva: World Health Organisation, 2005.

3.  Shennan A. Ed. Luesley D.M, Baker P.N, Obstetrics and Gynaecology, an evidence-based test for MRCOG. Chapter 7.6 1 Pre-eclampsia and nonproteinuric pregnancy induced hypertension. Arnold Publishing, 2004.

4.  Duley L, Henderson-Smart D.J, Meher S, King J.F. Antiplatelet agents for preventing pre-eclampsia and its complications (Review). The Cochrane Collaboration, 2007. John Wiley and Sons, Ltd.

5.  Hofmeyr G.J, Atallah A.N, Duley l. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. The Cochrane Collaboration, 2007. John Wiley and Sons, Ltd.

6.  Shennan A. Ed. Edmonds D.K, Dewhurst’s textbook of obstetrics and gynaecology. Chapter 25, Hypertensive Disorders, 7th Edition, Blackwell Publishing 2007.

7.  Knight M. on behalf of UKOSS. Eclampsia in the United Kingdom. BJOG 2007: 114; 1072-1078.

8.  RCOG Guideline No. 10 (A), March 2006.

9.  Duley L, Henderson-Stmart D. Magnesium sulphate versus phenytoin for eclampsia. Cochrane Database Syst Rev, 2003; (4): CD000127.

10.  Duley L, Henderson-Smart D. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev, 2003; (4): CD000127.

11.  Which anticonvulsant for women with pre-eclampsia? Evidence from the collaborative eclampsia trial. Lancet, 1995: 345

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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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