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 Medical notes...errrrm...ok...errr...what?

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thaiba2000
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PostSubject: Medical notes...errrrm...ok...errr...what?   Fri 22 Jan 2010, 8:18 am

Ive had my BIG PILE of medical notes for a little while now but after hearing that my friend has given birth to a healthy baby boy i decided to actually pick up the sheets of paper and read whats written on them. I have to admit i was crying for a good hour or two and while doing so decided to watch Babies at Risk on Sky Real lives channel to remind myself that i am lucky to have two gorgeous beautiful children! I decided to devide the Huge pile of notes into two as both my pregnancy notes are included. For some reason, as i was skimming through,some of it actually made sense compared to when they 1st came through the post i was like "Huh?". However as i seperated my 1st preg notes from my 2nd i realised that theres something that summed up both my pregnancies in one letter- i wish i had read this before. However there are some things i didnt understand in this certain letter...im just going to write out what t says in this certain paragraph.

Letter dated 4th septembe 2007 (my 2 nd pregnancy)

"Mrs Choudhury was reviewed for a special postnatal appointment six weeks after delivery. She had a sheduled caesarean section on 19 July 2007 at 33 weeks and 4 days gestation for significant Pre-eclampsia and massive proteinuria with IGUR and intermittent absent endiastolic flow."

The letter goes on to say that i was seen by the renal team and the scan was repoted as normal and that my renal functions were normal during pregnancy. The letter also states that "in view of her previsous pregnancies being affected with significant pre-eclampsia and IGUR, i would reccomend starting low dose aspirin, 75mg per day, right from the beginning of any subsequent pregnancies".

Ok so Can someone explain to me the 1st bit of the letter.... I have more to come because maybe this ia a positive thing. I need to know how bad i actually was during my pregnancies.

Thank you guys.

Also i realised that i had my dates wrong and my daughter was infact born at 33weeks and 4 days! I think thats quite good...well i dont know...maybe its a good thing....
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thaiba2000
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PostSubject: Re: Medical notes...errrrm...ok...errr...what?   Thu 06 May 2010, 10:30 pm

really cant wait for mr appointment to come through to see a PE Specialist BUT i need help with understanding the following things...i realy dont understand them and i dint even know if they are relevant or not...

1st pregnancy (son born 4th november 2003)

24 hour urine collection
22nd oct 2003
Urine volume 1.25 litres
Protein 1.76 g

2nd nov 2003
Urine volume 1.95 litres
Protein 4.33 g

3rd nov 03
Protein 1.27 g


At 35 weeks+2 days (24th oct 2003)
The fetal measurements are around the 5th centile, with a normal HC/AC ratio. The liquor volume and umbilical artery Doppler are normal. She reports normal fetal movements.
Doppler is of limited value at this gestation. Asses growth and liquor in 2 weeks in concerns persist.

36+5
S/D 3.0
PI 1.05

LV: decreased, one pool of 3cm
Prosteria placenta clear of OS.



Im not going to write down all of BP readings but here are some,

1st nov 03
9.20am +3 protein Asymptomatic 138bpm
2.38pm 150/86 +3 protein
7.00pm 128/103
10.00pm 134/83

2nd november
9.45am 122/88 Asymptomatic +3 protein
10.00pm 131/86 130bpm

3rd Nov 03
11.00am 125/90 +2 protein
12.05am 135/100
3.00pm 140/90 +2 protein

When transferred to delivery suite to be induced i had BP
6pm 155/103
6.25pm 166/100
6.45pm 105/85

Post op bp reading (straight after C-section)
2.55am 130/67
5.00am 139/76
6.00am 131/81
7.00am 146/78
9.00am 172/101
10am 142/82
11am 137/67


Next time will be my daughters info along with the placenta analysis for both pregs. Sorry. Just need to know how bad the readings etc are and what they mean. Especially how bad the protein in urine was.
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thaiba2000
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PostSubject: Re: Medical notes...errrrm...ok...errr...what?   Fri 07 May 2010, 11:09 am

2nd Pregnancy (daughter born 19th july 2007)

24 hour urine collection

4th July 07
urine volume 2.10 litres
urine protein 1.39 g

10th July 07
Urine volume 1.70 Litres
Urine Protein 6.49 g

14th july 07
Urine volume 1.20 Litres
Urine Protein 9.18 g


Blood pressure

2nd july
4.25pm 140/85 +2 protein
8.00pm 133/92 "

3rd july
6.00am 116/72
10.25am 130/86 +2 protein
10.30PM 128/80

10th july
8pm 137/97
11.45 148/90 +3 protein

12 july
10.40pm 144/84

13th july
6.35am 146/92
10.20am 124/65

14th july
10.45pm 133/79

15th july
7.00am 153/92 +3 protein

17th july 144/101 even with blood pressure medication

19th july
6am 157/89
8am 142/88
7pm tansferred to delivery suite for LSCS 180/90
straight after C-section 116/66
9pm 145/89
9.45pm 140/90
10pm 140/88
10.30pm 153/92
11pm 152/85

on the 19th july-
Asymtomatic. Bp stable on Methyldopa 500mg TDS. Continues to have massive proenuria-last 24hours urine pretein 9mg/day. Serum albumin 18. LFT, U&E platelet normal. Maternal renal USS normal.

Fetus active. Growth velocity restricted- AC just below 5th centile. Intermittent absent end diastolic flow in the umbillical arteries. Impossible to check MCA doppler. Bilateral high resistance flow in uterine arteries.

PLAN- scheduled LSCS today or tomrow depending on the situation in the NNU and delivery unit.





well ok, thats enough now i think. It said that my bp settled. I really dont know why i typed all that up...i think it made me feel a little better.
I just want to know when is BP dangerously high and was i at the highest at any point?
Also whats the danger limit on Proetin in the urine???
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jules
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PostSubject: Re: Medical notes...errrrm...ok...errr...what?   Mon 10 May 2010, 11:12 am

I'm not a doctor nor an expert but my first impression is that your BP was not really bad. 160/100 or above is considered to be a marker of severe PE; and although you had occasional readings over this level, you didn't have consistent readings above this level. At my worst, I had a BP of consistently around 230/110, despite being on maxmial doses of three different blood pressure lowering medications intra-venously. That was very severe but my Obstetrician still told me he'd seen worse. Despite having very severe PE and HELLP I still made a full recovery physically.

Your protein was pretty high, but doctors seem to worry less about this as the kidneys are generally pretty robust and bounce back well.

Its easy for me to sit here and say that your case was not that severe though (in comparison with mine). Your still had PE which inevitably put you at some risk, and your babies were both significantly affected too, in the sense that they were very growth restricted. You need to speak with the experts really.
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