Preeclampsia (Critical Diagnosis)

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Health & Fitness, Science, Education, Medicine, Life Sciences

4.9 • 816 Ratings

🗓️ 23 May 2016

⏱️ 9 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Never ignore a pregnant woman’s blood pressure.

Introduction

* Pre-Eclampsia* Pathophysiology unknown* Pregnancy induced multi-organ dysfunction* Definition* Pregnancy* PLUS* BP 135/85* PLUS* Proteinuria* Eclampsia* Preeclampsia* PLUS* Seizures* HELLP Syndrome* Preeclampsia* PLUS* Hemolysis* PLUS* Elevated liver enzymes* PLUS* Low platelets

Step 1: Evaluate For Four Big Symptoms

* Swelling/edema* Headache* Visual changes* Abdominal pain

Step 2: Testing

* Urinalysis* Proteinuria* CBC* Hemolysis* Thrombocytopenia* Electrolytes* Liver function tests

Step 3: Start Magnesium

* Hypomagnesemia = Hyporeflexia

Step 4: Control the Blood Pressure

* Hydralazine* Labetalol

Step 5: Admit

* OB emergency* All patients need fetal monitoring

Additional Reading

* Round 2 – Seizure (EM Clerkship)* Preeclampsia and High Blood Pressure During Pregnancy (ACOG)

Transcript

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0:00.0	Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of
0:07.1	endless charting once you become a doctor? Do you think that doctors should be spending more
0:11.9	time with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a
0:20.4	secure, hippocompliant scribe that anybody can use.
0:24.7	Focus your energy on what matters, providing good patient care.
0:29.5	Use coupon code EM50 to save 50% the first month you try it,
0:34.1	and you can cancel at any time if you decide it's not right for you. You can learn more
0:38.9	at www.gitfreed.a.i. Hello, med students. My name is Zach Olson, and today I'm going to be
0:50.5	mixing it up by trying something a little bit different. I've been getting some really great feedback from people about how much they are enjoying these general approach episodes, which is super awesome.
1:02.1	And for those of you who have emailed me and have reached out, I really appreciate it.
1:06.8	Because every one of those emails have literally just made my day, especially for a new podcast,
1:11.8	they have pushed me to keep trying to create the highest quality of content possible.
1:17.8	But as I've been recording, I've also been thinking.
1:21.2	It's probably important to occasionally mix things up to keep things from becoming too repetitive from week to week to week.
1:29.1	Because the last thing I want is to start so strong and then for you guys to stop downloading
1:34.1	because you're getting bored. So what I'm going to do is I'm going to start posting occasional
1:39.3	podcasts that go a little more in depth, specifically on the critical can't miss diagnoses of emergency medicine.
1:48.3	There's still going to be 10 minutes or less. Don't worry about that. It's just that the content is going to be more focused.
1:55.2	And so that's what we're going to be doing today. Shoot me an email. Let me know how you end up liking it.
1:59.8	But here we go. Let's try this.
2:02.2	Today, we are going to talk about the critical diagnosis preeclampsia.
2:08.4	And I'm super excited about this topic right now because I'm actually writing it with my attending during my OB rotation.
	...

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