A Pregnancy Complication to Look out for even after Pregnancy

​BY GREGORY TAYLOR, DO, & SHERIF G. EL-ALAYLI, DOA 30-year-old G5P3 presented to the ED with bilateral lower-extremity edema and headache for three days. She presented one week after an uncomplicated full-term vaginal delivery with an unremarkable pregnancy course and no prior requirement for antihypertensive therapy. The headache was described as achy to sharp, with associated photophobia. She also noted occasional vaginal spotting, which was common a few weeks after delivery. She denied any chest pain, shortness of breath, nausea or vomiting, abdominal pain, or any other symptoms. She admitted to occasional mild cramping with minimal lochia.The patient was afebrile. Her vitals on arrival included a blood pressure of 168/94 mm Hg, heart rate of 82 bpm, respiratory rate of 18 bpm, and 100% on room air. Laboratory evaluation was notable for a hemoglobin of 11.1 g/dL, an aspartate aminotransferase of 44 U/L (13-39), alanine aminotransferase of 131 U/L (7-52), and a uric acid of 8.4 mg/dL (2.5-7.5). The clinical presentation and laboratory evaluation were concerning for postpartum preeclampsia.Hypertensive disorders of the antepartum and postpartum period (preeclampsia, eclampsia, HELLP, and cardiomyopathy) complicate up to 10 percent of all pregnancies around the world. (ACOG, 2017; http://bit.ly/2n5Pnhf.) These become common causes of maternal and perinatal morbidity and mortality. (EMRA. Jan. 31, 2018; http://bit.ly/2n56VKc.) Postpartum preeclampsia ma...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research