![]() ![]() She remained without a carotid pulse and unresponsive to atropine and epinephrine. ![]() The patient's cardiovascular status did not improve after delivery. The baby's Apgar scores were 4 at 1 minute and 8 at 5 minutes. An emergency cesarean section was performed. The patient was intubated and ventilated with 100% oxygen, but remained cyanotic. Cardiopulmonary resuscitation was initiated. At approximately 18:30 she became pulseless. An emergent sonogram showed a heart rate around 60/minute and dropping. The fetal heart rate was difficult to ascertain with the electrode. Fetal heart tones were difficult to auscultate externally and a fetal scalp electrode was applied. The patient initially had a palpable pulse and sustained respiratory effort. An anesthesiologist, who had been in the next room, entered the room and found the patient unresponsive and cyanotic, with tonic-clonic seizure activity. The husband ran out of the room to summon help. Labor proceeded uneventfully, with the cervix dilated to 5 cm, until about nine hours after admission.Īt approximately 18:15, according to the husband, the patient sat up and reported the sudden onset of deep back, rib and flank pain, and shortness of breath. A total of 24 MU of oxytocin was given from 13:30 to 18:15. An intravenous infusion of lactated Ringer's solution was started, and the patient received prophylactic penicillin. At 10:15 the patient's hemoglobin was 11.6 g/dL. Fetal heart rate was normal at 120-130/minute. The patient's temperature was 36.3 o C, pulse 86/minute, blood pressure 135/85 mm Hg and respirations 20/minute. Her outpatient medications included only salmeterol/fluticasone inhaler for asthma, and prenatal vitamins. She was having irregular mild contractions. This 35-year-old mother of two was admitted to an urban hospital in the Midwest USA at 37 4/7 weeks gestation at 09:21 with spontaneous rupture of membranes since 04:00.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |