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Old 05-16-2012
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ObGyn HELLP Syndrome, Next Step in Management?

Patient diagnosed with HELLP syndrome....

The patient is admitted to the hospital. A fetal heart tracing shows short term variability > 5 beats/min and long term variability of 6/min (normal 3 -1 0). Which of the following is the most appropriate next step in management?

A. Administer corticosteroids and observe in the hospital for fetal lung maturity
B. Administer magnesium sulfate and induce labor immediately
C. Administer a platelet transfusion and obtain a HIDA scan
D. Performa emergent plasmapheresis
E. Contact the nearest liver transplant facility for immediate transfer
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Old 05-16-2012
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B...HELLP is considered a severe preeclampsia..so the definitive treatment is labor...so you give the magnesium for prevention of eclampsia and induce labor
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Old 05-16-2012
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Like what halabian said get rid of the child/placenta as soon as possible
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Old 05-16-2012
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B.immediate termination
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Old 05-16-2012
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Quote:
Originally Posted by tyagee View Post
Patient diagnosed with HELLP syndrome....

The patient is admitted to the hospital. A fetal heart tracing shows short term variability > 5 beats/min and long term variability of 6/min (normal 3 -1 0). Which of the following is the most appropriate next step in management?

A. Administer corticosteroids and observe in the hospital for fetal lung maturity
B. Administer magnesium sulfate and induce labor immediately
C. Administer a platelet transfusion and obtain a HIDA scan
D. Performa emergent plasmapheresis
E. Contact the nearest liver transplant facility for immediate transfer
what does this mean ? [highlighted in red]
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Old 05-17-2012
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What i know is that Short term variability if deceased, this will be non reassuring sign but a decrease in longterm variability reflect sleepy baby
This 2 terms only mentioned together in uworld but in kapalan it only mention variability in general ?
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Old 05-17-2012
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B. Administer magnesium sulfate and induce labor immediately
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Old 05-17-2012
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Quote:
Originally Posted by tyagee View Post
Patient diagnosed with HELLP syndrome....

The patient is admitted to the hospital. A fetal heart tracing shows short term variability > 5 beats/min and long term variability of 6/min (normal 3 -1 0). Which of the following is the most appropriate next step in management?

A. Administer corticosteroids and observe in the hospital for fetal lung maturity
B. Administer magnesium sulfate and induce labor immediately
C. Administer a platelet transfusion and obtain a HIDA scan
D. Performa emergent plasmapheresis
E. Contact the nearest liver transplant facility for immediate transfer
i hope that her gestational age should be given.
According to u world, >34wks.... prompt delivery and ,<34 wks depend on the mother and fetus status.
According Kaplan, Prompt delivery at any gestation age is appropriate.
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