Another wierd bad thing

Specialties Ob/Gyn

Published

Hi all,

Yesterday, I was in charge on our high-risk ob floor. A post-partum patient who had a c-section the day previous came back from the postpartum floor. Apparently, after having been up and about, foley out, been to the nursery to see baby, etc. the patient started complaining at about 1545 of blurry vision. She was a mild preeclamptic who had had a c-section under general anesthesia. Labs were drawn and were normal. She then said that she couldn't see colors, then lost vision altogether. They took her down for CT which was normal. (This pt is 17 yrs old). Then she came over to L&D. Neurology came up, said her pupils were reactive, did all kinds of bedside neuro exam. I got IV going, drew labs, tox screen, (neg), and she was thrashing around and mumbling incoherently. We put her in four-point restraints, at which time she calmed a little bit. Then the neuro guy said her pupils weren't reactive anymore. Her pulse was fluctuating from 60's to 100's up to 200 at one point. Pressure 170/95.

Now she's in the unit intubated and the neuro says maybe she had a stroke of the hippocampus and the pons, or maybe it's atypical preeclampsia, or maybe who knows. Nobody knows what's wrong with this chick. The family, of course, is hysterical.

Anybody heard of anything like this??? Everyone here is baffled. MRI showed diffuse infarcts as far as I could find out.

It was the wierdest thing I think I've ever seen.

Lisa:confused: :confused:

Specializes in Labor & Delivery.

I am so sorry at the result, It does sound like she stroked out. We always maintain the Mgso4 for 24 hrs post delivery - they can seize up to 2 weeks postdelivery

A good point was made -- we should ALWAYs know a pt's usual BP - 120/80 is high for a pt whose USUAL bp is 90/50

OMG, that is very sad news:o

Specializes in Med-surg; OB/Well baby; pulmonology; RTS.

It does sound like she stroked out-with an MRI showing diffuse infarcts. And her being 17 y/o-THAT IS SO SAD!:o

I am curious as to what her medical history was: lupus? previous HTN? diabetes? Sorry to ramble but that is so scary!

I, too, had PIH with my baby-it gives me (((chills))) to think about this poor girl and her family.

Ginger

No past medical history, no past surgical history. Still no diagnosis. Will keep you all posted. Thanks for the kind words. It's a shame they can't come from my own administration. All we hear from them is what we could documented better, etc., etc. Oh well, you have to be in the trenches to really empathize, and I thank you all.

wow. this is terrible. poor girl. poor baby and family.

over the w/e we had a pt. who del at another hospital abt. 2 wks ago at another hospital who came to er seizing. they dc'd her w/ n/o seizure d.o. guess what? she did it again on the way home and was back to the hospital. after a couple more seizures and a stay on a med floor, ob was called in. she did have inc. bp when tx'd for seizures and had mild pih, but no labs were ever done, she was just induced. we got her for a couple of days for mag. no more seizures after that. she did have inc. lft's. scary huh? it is pretty rare for eclampsia so long after delivery, but as you can see, not impossible.

My God. I just now read this and am shocked. I hate to hear of things like this.

In the last 20 years, thankfully, I've only had two PIHers stroke out and die. I did have one who had an MI during labor but she survived. What a horrible, horrible tragedy for the family and that poor little baby. They are in my prayers and so are you. Remember you are going through the grief process too. Isn't it amazing that, with all our technology, we can still lose MOMS. God bless you and please keep us posted. We're here if you need us. Sherry

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