A 21-year-old African-American - lascrusesdoc

[ArchivalUser]

A 21-year-old African-American primigravida is brought to the emergency department ten minutes after giving birth to an infant at home. She received no prenatal care. Her past medical history is insignificant. Her blood pressure is 150/95 mmHg, and heart rate is 100/min. Physical examination reveals an enlarged, tender liver and 2+ symmetrical edema of the lower extremities. The platelet count is 50,000 cells/mL. Schistocytes are present on the peripheral blood smear. AST and ALT are elevated. The urine is positive for 2+ proteins. What is the best next step in the management of this patient?

Options

1. Immediate manual removal of the placenta
2. Magnesium sulfate infusion
3. Hydralazine infusion
4. Plasma exchange transfusion
5. Nifedipine, oral

[ArchivalUser]

1. Immediate manual removal of the placenta

the main and important treatment for HELLP is delivery the baby and all its contents.

[ArchivalUser]

b mg

[ArchivalUser]

11

[ArchivalUser]

2. Magnesium sulfate infusion

[ArchivalUser]

she had preclampsia with help syndrome, give mgso4

[ArchivalUser]

this is prophylactic to decrease chance of eclampsia as no information of placenta avaialble

[ArchivalUser]

2...

[ArchivalUser]

I think the answer is 1.She is a primi and she presents 10mins after giving birth.The 3rd stage of labor is about 30mins so i think the placenta is still in-situ.In HELPP,the main aim of tx should be to deliver the baby and the remaining POC.

[ArchivalUser]

give MgSo4