Case Presentation #2: Cassio's OB Patient

[cassioo]

I suggested the gallbladder/pancretitis to the OB because I had pancretitis that was the worst pain ever (and almost killed me that was after having 3 vag and 1 c/s they didn't even compair to the pancretitis)....however normal Amylase and lipase decided that wasn't it (and it wasn't)

She was a previous normal vag no problems, no abd surgery

When ready I'll let you know the outcome

(yep I know what the G&P mean didn't even read that part)

[orionseal]

I give.
The only other presentation I can think of is a possible rupture or abruption but you already struck that one down.

Now this is far fetched but here goes.(this is wild and off the cuff) She has a tubal pregnancy or ovarian cist alongside her exsisting fetus.(Far fetched but it's all I got) (I'llobably be kicking myself after you tell us though).

Charlie

[RNCMSN]

She could be constipated. It could be trapped gas. In my assessment I would ask about her bowel habits, listen for bowel sounds, palpate and check for tympany. Prenatal vitamins and iron can cause constipation along with compression from the growing uterus. It can also impede lung expansion explaining the 02 saturation. What say you oh great Cassio?

[njohnso4]

Oh my gosh I'm on the edge of my seat!!!

[RNCMSN]

yeah, me too. Do we need a specialist?

[cassioo]

Sorry, tried to post the result a couple of days ago and for some reason the posting wasn't working...

Yep we need a specialist. You don't want to cut out a premie if you don't have to....

I'd also thought fatty liver of pregnancy (look that one up) it kind of looks like preeclampsia.....

This lady got transfered by ambulance (I got to ride for the 2+ hr trip she was on mag) to a large teaching hospital where they ran further tests and more extensive sonos................scroll down






This lady had..... HEP C that's where the pain came from. AND the more extensive sono showed that the baby had a severe heart problem that regular OB sono hadn't picked up. She was given some med and sent home after another week where she went to term but had to deliver at that teaching hospital where the baby went for immediate surgery (sorry don't know baby outcome I left the building)

[Robert F]

Yeah, that was due to our upgrading of the entire system and switching servers. The Forum is now up and stable.

Thank you for an interesting and informative case study Cassio. I will begin working on Case Study #3 in about a week(I am currently swamped in program code trying to get this server change knocked out.)

I will make sure to keep it interesting.