Lab Results: WOW

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Specializes in PERI OPERATIVE.

Ok, so we have this HELLP/Preeclamptic pt who had a c-section yesterday. She has been on mag since before delivery.

Anyway, her platelets this morning were 50. SGPT/ALT was 233 and SGOT/AST was 372.

I'm freaking out as these labs seem critical to me, but the OB/GYN says this is to be expected and they should normalize shortly.

What have you experienced with preeclampsia and labs?

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Specializes in med-surg, telemetry,geriatrics.

Not in OB but isn't that part of HELLP syndrome. I would think that would be suspect in this case.

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Specializes in Nurse Manager, Labor and Delivery.

This is HELLP syndrome and although expected, they are critical labs. I hope the OB continues to draw labs regularly to monitor the platelets.

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Specializes in PERI OPERATIVE.

I know this is all associated with HELLP. Just wondering if anyone has experienced labs like this.

Her platelets are now 37!! OB not concerned yet.

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Specializes in Nurse Manager, Labor and Delivery.

The funny thing about HELLP is that either they have horrifying labs and they don't appear sick, or their labs aren't horrifying and they are sick. I had a girl years ago that had both. She ended up with platelets of 19 and was just sick as a dog. She got transferred to ICU and ended up oozing from IV sites and having lots of pain. She did hang in low platelet land for a few days before they started going back up. The OB was in contact with tertiary care center and with our hemotologists in case of further complications. It is really scary. We don't see this type of patient so much, so maybe that is why I would be more un-nerved than your OB seems to be. I wonder what his low platelet level would be??

Same patient had liver enzymes over 900. Sick one she was.

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Specializes in PERI OPERATIVE.

The OB said she'll be concerned if it gets lower than 20. When that happens you'll see my butt wheeling her down to ICU!!

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Specializes in Community, OB, Nursery.

Our OBs start twisting their knickers when plts hit about 30ish. Ugh. Of all the things out there, I hate preex more than anything else. They can be fine, fine, fine, then BAM! they crash in a couple hours. :( Hang in there!!

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Specializes in Family Practice.

our docs would be txfring a pt if their plts were close 70!! our facility doesn't have platelets to transfuse on hand. we have to specially order for them and it takes time to get them here. i seen a pt a couple of yrs ago we were txfring and her plts were in the 70's, we sent her down the road asap and as soon as the transport team got through the accepting facilities door she bled out and the baby died. i think she was 24-25 weeks.

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