Thanks for sharing your knowledge & experience, Jenny. I remembered the increased blood volume & therefore low blood pressure. Good to know I was on the right track :o)
Cheers, Jen --- Jenny Cameron <[EMAIL PROTECTED]> wrote: > Hello Jen > > I would explain what is most likely to have happened > and I would advise her > to come in for a check ASAP. Common sense would say > this was physiological > and just the result of a long hot day's shopping and > low BP. Remember the > effect of increase in blood volume is at its peak at > about this time > (24-32/52), so BP is likely to be a bit lower than > normal plus if she was > hot she was probably vasodilated++. It is > impossible to categorically say > there is nothing wrong in a telephone consult and as > we are obliged to > document all contacts with the women in our care, > then we have little choice > but to recommend she comes in for a check, or you go > out & visit. Also if > she freaked out the quick check will reassure her. > If she doesn't want to > come in or have a visit, then document what you > recommended. Probably 20 > years ago I would have reassured her, but standards > of risk management have > altered the playing field. In my experience if it > was > pre-eclampsia/eclampsia then she would not recover, > she would remain unwell. > Always think, 'First do no harm'. > > Jennifer Cameron FRCNA FACM > ProMid > Professional Midwifery Education Service > 0419 528 717 > ----- Original Message ----- > From: "Jen Semple" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Wednesday, November 17, 2004 8:45 PM > Subject: Re: [ozmidwifery] seizure at birth > > > > Whew, that pretty much answers all of my > questions! > > Thanks very much for taking the time to share your > > knowledge & experience, Jenny. > > > > Whoops, thought of another question! Black outs > > reminds me... I have a friend who had a black out > when > > she was about 30/40 during a long day of shopping. > > > > She was having an uneventful pregnancy, > normotensive, > > etc. Had lots of baby movements both before & > after > > the blackout. But was understandably freaked out > > after the blackout. > > > > If you were her midwife & she rang you describing > > this, what would you suggest to her? > > > > She went on to have a gorgeous baby at term in a > birth > > centre. > > > > Jen > > > > > > --- Jenny Cameron <[EMAIL PROTECTED]> wrote: > >> Most unusual. Usual practice would assume > eclampsia > >> until proven otherwise. > >> I once had a woman, normotensive, postdates & > >> multigravid have a grand mal > >> seizure immediately following an ARM for > induction > >> of labour. Fortunately > >> the Obs was just outside the door washing his > hands. > >> On questioning she gave > >> a history of frequent blackouts during pregnancy. > >> Didn't think to report it! > >> Subsequently diagnosed as epileptic. The actual > >> seizure is not a problem for > >> the woman (we need to protect her from physical > >> injury). It is certainly a > >> problem if the baby is still in utero as he will > be > >> anoxic for the period of > >> the seizure. The major morbidity for the woman > >> arises from the ischaemic > >> cerebral damage and possible stroke from the > >> hypertension. Never, ever > >> underestimate pre-eclampsia. Beware of the woman > >> with upper epigastric pain > >> and be very wary of the 'twitchy' woman. New > grads > >> don't be afraid but be > >> vigilant. Women rarely become eclamptic without > some > >> warning. Medical > >> science is very good at detecting pre-eclampsia. > The > >> management of > >> pre-eclampsia has changed dramatically over the > >> period of time I have been a > >> midwife. It so much better now. > >> > >> As far as midwifery responsibility, if a woman > >> seizures, you need to > >> 1) Call for urgent medical help > >> 2) Protect her from injury > >> 3) Take BP. > >> 4) Prepare for medication to lower hypertension.. > >> 5) Monitor the baby...N.B.mother takes priority. > If > >> she is well oxygenated > >> the baby will be. Therefore sort her out first. > >> Happy midwifing > >> Jenny > >> > >> Jennifer Cameron FRCNA FACM > >> ProMid > >> Professional Midwifery Education Service > >> 0419 528 717 > > > > Find local movie times and trailers on Yahoo! > Movies. > > http://au.movies.yahoo.com > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit <http://www.acegraphics.com.au> to subscribe > or unsubscribe. > > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe > or unsubscribe. > Find local movie times and trailers on Yahoo! Movies. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
