ABSTRACT
BACKGROUND: Coexisting medical complications in pregnancy can present in a fashion similar to preeclampsia and can be challenging to differentiate. CASE: We present a patient who, at 27 3/7 weeks of gestation, fulfilled diagnostic criteria for severe preeclampsia, including hypertension, proteinuria, headache, abnormal serum creatinine levels, thrombocytopenia, and liver function abnormalities, but who nevertheless did not have preeclampsia. Instead, she was diagnosed with alcoholic pancreatitis based on a history of heavy alcohol use and elevated amylase and lipase. Abnormal laboratory values resolved with supportive therapy, and she continued to term without subsequent recurrence of proteinuria or hypertension. CONCLUSION: Alcoholic pancreatitis can be mistaken for preeclampsia.
Subject(s)
Pancreatitis, Alcoholic/diagnosis , Pre-Eclampsia/diagnosis , Adult , Diagnosis, Differential , Female , Humans , PregnancyABSTRACT
OBJECTIVE: We sought to evaluate the use of the Ronald McDonald House (RMH) for selected high-risk pregnant women. METHODS: Beginning in November of 1999, women on the Maternal Fetal Medicine service at Albany Medical Center Hospital (AMCH) were candidates for antepartum lodging at the Ronald McDonald House (RMH). Women whose only indication for antepartum hospitalization was to maintain proximity to a tertiary care center were offered stays at the RMH. Antenatal and neonatal outcomes were reviewed. RESULTS: A total of 41 antepartum subjects stayed at the RMH during the study period. No adverse perinatal outcomes were identified due to utilization of the RMH. Patients stayed at the RMH instead of staying at AMCH as inpatients for a total of 586 days during the study period. CONCLUSIONS: Outpatient management at the RMH is a cost-effective alternative for selected high-risk pregnancies. No adverse outcomes in the study population were attributable to the utilization of the RMH.
Subject(s)
Pregnancy Outcome , Pregnancy, High-Risk , Prenatal Care/methods , Residential Facilities/statistics & numerical data , Adult , Bed Rest , Environment , Female , Follow-Up Studies , Hospitalization , Humans , Maternal Health Services , Obstetric Labor, Premature/prevention & control , Pregnancy , Sampling StudiesABSTRACT
OBJECTIVE: We sought to assess the gestational age at which elective delivery is considered in an otherwise uncomplicated patient with preterm premature rupture of the membranes (PROM) by members of the Society of Maternal Fetal-Medicine (SMFM). STUDY DESIGN: A 3-page survey was mailed to members of the SMFM for this observational study. Information solicited included demographic data and practice patterns for the timing of delivery in patients with preterm PROM. RESULTS: Seven hundred seventeen questionnaires (40%) were completed. The majority (81%) did not believe there is a consensus regarding the gestational age for elective delivery in patients with preterm PROM. With confirmed fetal lung maturity, the greatest number of respondents selected 32 and 34 weeks as the earliest gestational age for elective delivery. In the absence of fetal pulmonary maturity testing, the majority of respondents chose 34 weeks. CONCLUSION: Most SMFM respondents electively deliver uncomplicated patients with preterm PROM by 34 weeks' gestation.
