Reflex and Pic Essay

Paige is a 25yo, G3 P1011, who is currently 30 weeks 6 days. She is followed in our office after being admitted to the hospital for abruption with a positive KB and decreasing fibrinogen. Her fibrinogen stabilized around 200. She had no more vaginal bleeding and she was discharged home. When she came in she was also contracting and noted to be 2 cm and have a shortened cervical length at 1.9 cm that decreased down to 1.2 cm with pressure. She was ultimately discharged home and has been home for about one week. She is here today for follow-up.

In several occasions, pregnant women complain about dyspnea condition. Due to the unclear mechanism of pregnancy dyspnea, it is quite a challenge to distinguish between physiologic changes induced dyspnea (i.e. endocrine system changes) and underlying diseases induced dyspnea. There are some pregnancy-specific causes of respiratory failure including amniotic fluid embolism and pulmonary edema secondary to tocolytics, preeclampsia/eclampsia, or pregnancy-associated cardiomyopathy (peripartum cardiomyopathy).

Reflexology is the theory that the human body can be healed from disease or imbalance through pressure to specific points on the hands, feet, and ears (http://www.doubleclickd.com/reflexology.html). This alternative form of healing is doubted by many, although there are studies that support its theory.

HELLP syndrome is a life threatening obstetric complication usually considered to a complication of pre-eclampsia. HELLP has 3 components- Hemolysis ,Elevated liver enzymes and low platelets. Early symptoms can include epigastric pain, malaise, nausea or vomiting. There can be headache, blurred vision and paresthesia also. This patient has elevated liver enzymes and low platelet count and with an hematocrit of 26% ,she may have hemolytic anemia also. If HELLP is misdiagnosed in the early stages, it can lead to permanent liver failure. The only effective treatment is prompt deliver with induction of labor by I/V oxytocin along with I/V MgSO4 to prevent seizures. This patient is the perfect candidate for this treatment as her cervix is 2 cm dilated and 50% effaced. Delivery of the fetus usually results in rapid improvement in

Thank you for the opportunity to again participate in the care of Ms. Melissa Williams, who currently is inpatient with expectant management of her severe preeclampsia. She has had fairly controlled BP’s on her current regimen reported as hydralazine 10 mg t.i.d. and labetalol b.i.d. Her BP’s since the time of our last consultation have remained in the mildly elevated range, mostly in the 150’s to low 160’s over 80’s to 90’s. On review of her labs it appears that her liver function tests started to increase yesterday and on review of today’s labs her platelet count has decreased down to 130,000 and she has an elevation in her liver function test with an AST of 113 today and ALT of 135. With the liver function tests more than

Although rare, spontaneous bleeding is the main maternal risk especially when the platelet count falls below 20,000/µL. Steroids or IVIG are recommended before 36 weeks if platelet count is under 30,000/µL, the patient is symptomatic or an invasive procedure is considered.7 Around delivery, the aim is to maintain platelet count above 50,000/µL, the level considered safe for both vaginal and cesarean delivery. Intravenous immunoglobulin at a dose of 1 g/kg have a relatively rapid therapeutic response (within 1-3 days) or prednisone 1 mg/kg with a therapeutic response within 2-14 days could be used for treatment during pregnancy. The first-line therapy drug, prednisone, is considered safe, but can induce or exacerbate gestational diabetes, maternal hypertension, osteoporosis, weight gain and psychosis. Prednisone is metabolized by placenta but high doses have been linked to fetal adrenal suppression and a small increase in incidence of cleft lip and palate if used in the first trimester.8

“It is believed that HELLP syndrome affects about 0.2 to 0.6 percent of all pregnancies” (American Pregnancy Assosiation, 2016, para 1). HELLP stands for hemolysis, elevated liver enzymes, and low platelet count. Although the cause to HELLP syndrome is still unkown, there are several signs and symptoms the pregnant patient and her health care provider should be aware of in order to prevent serious and life threatening consequenses to the mother and baby.

HELLP Syndrome, an acronym that stands for Hemolysis, Elevated Liver Enzymes, and Low Platelets. HELLP Syndrome is a serious pregnancy complication that is life threatening. It is related to a health condition called preeclampsia, which is caused by pregnancy induced hypertension. According to the Preeclampsia Foundation (2010) worldwide, preeclampsia and other hypertensive disorders such as HELLP Syndrome, or eclampsia are a leading cause of maternal and infant death and illness. It is estimated that these

And it is caused by great psychological stress. Hypertension affects the mother and child during pregnancy, and the medicine that doctors ask women to take for depression, while pregnant can increase the negative effects of hypertension. The hypertension can cause preeclampsia, which can lead to severe damage to you and your child. Once you have preeclampsia you must deliver your baby right than. Hypertension can also affect the child too, it can affect the newborn's heart, and lungs. Newborns coming outside of the womb actually have to be put on immediate care. The child you were carrying for 9 months will be put on immediate care because of the mediation you took while you were pregnant. While possibly curing the mother's depression, it can lead to other negative effects along the

When a woman is pregnant, any risk to herself or her baby is a significant problem. How many women suffer from Preeclampsia? Out of five to ten women. A woman who had a normal blood pressure before pregnancy can develop high blood pressure and excess proteins in her urine after the first twenty weeks of pregnancy. When this occurs a woman is told she has a disease named preeclampsia, which puts her baby and herself at risk. Preeclampsia grows unexpectedly after twenty weeks, with a high increase in blood pressure, excess proteins in her urine, extreme headaches, nausea, dizziness, sudden weight gain as sudden symptoms as sudden signs of sickness.

Preeclampsia is a condition that occurs only during pregnancy. Some symptoms of preeclampsia may include high blood pressure and protein in the urine, occurring after week 20 of pregnancy. Preeclampsia is often precluded by gestational hypertension. While high blood pressure during pregnancy does not necessarily indicate preeclampsia, it may be a sign of another problem. Preeclampsia affects at least 3-5% of pregnancies. If undiagnosed, preeclampsia can lead to eclampsia, a serious condition that can put pregnant women and their baby at risk, and in rare cases, cause death. Women with preeclampsia who have seizures are considered to have eclampsia. The exact causes of preeclampsia and eclampsia a result of a placenta that doesn't function properly

As nurses we vow to encourage, teach, and support our patients throughout the lifespan. Precipitous labor is a topic that not only

Maria arrived at Alice Springs maternity unit complaining of headache; her blood pressure was 160/120mmhg measured manually. She had peripheral pitting oedema in her legs, proteinuria 4+, oliguria and elevated uric acid. Lisonkova and Joseph (2013) make a strong case that late-onset preeclampsia is associated with younger maternal age and nulliparity which correlated with the background of the woman under my care. While pre-eclampsia is generally diagnosed on the basis of hypertension and proteinuria (Pettit & Brown, 2012), Lewis (2011) classify these parameters as inaccurate and non specific markers. The reasons come from two directions. First they are only present in 15-20% of all pregnant women (Lewis, 2011). Second, they are just two signs of progressive circulatory malfunction and inflammation of the placenta (Lewis, 2011).

By managing your weight and following a nutritious diet, exercising regularly, and avoiding potential harmful substances like lead and radiation can decrease the risk of complications during pregnancy and protect the infant’s development (National Institutes of Health, 2014). Pregnant women with existing conditions such as diabetes and high blood pressure are at risk of preeclampsia/eclampsia therefor should take extra precautions monitoring their condition (National Institutes of Health, 2014). According to the article The Global Impact of Preeclampsia and Eclampsia by Leila

The sign and symptoms of PPH include; the apparent excessive bleeding, hematocrit-reduction of the number of red blood cells, reduced blood pressure, development of symptoms of shock and anaemia, and severe pain and swelling of tissues and muscles of the vagina, vulva, pelvic and perineum (Simpson & Creehan, 2008). Besides, Ricci & Kyle (2009) avow that there are different factors that place a mother at risk for PPH, and they comprise; prolonged first, second or third stage of labour, previous history of PPH, foetal macrosomia, uterine infection, arrest of descent and multiple gestation. Other risk factors may include; mediolateral episiotomy, coagulation abnormalities, maternal hypertension, maternal exhaustion, malnutrition or anaemia, preeclampsia, precipitous birth, polyhydramnios and previous placenta previa (Ricci & Kyle, 2009).