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Headache at 30 weeks of gestation, A benign tumour of the pituitary…

- - - - Protein S & C test (Lab)
        
        Protein C & S deficiency
      - FBC(Lab)
        
        Polycythaemia
        
        Leukocytosis
        
        Thrombocytopenia
      - Urinalysis(Lab)
        
        Protein (TRO nephrotic syndrome)
        
        Leukocytosis (TRO infection)
        
        LFT (TRO cirrhosis)
      - Imaging
        
        MRI venogram
        
        CT venogram
      - APTT - Coagulation Profile
  - - - Alteplase
    - - Low molecular weight heparin
      - Warfarin not recommended
- - - - chronic D: DM, chronic HPT, CKD
      - autoimmune D: SLE, APS
      - previous PIH
    - - primigravida
      - age
      - BMI >35 during first visit
      - interval pregnancy more than 10 years
      - family history PE
      - multiple pregnancy
  - - - Dt to Subcapsular hemmorage - liver
  - - - CTG
      - TAS: AFI, fetal parameter, doppler
    - - fbc
      - RP,LFT
      - urine PCR
      - Coagulation profile
  - - - aim deliver at 38 weeks
      - indication to expedite delivery: inability to control BP, deterioration of liver and renal, fetal distress, progressive thrombocytopenia
    - - aim diastolic (90-100)
      - if severe PE:
        -MgSo4 ( prevent eclampsia),
        -IM dexamethasone if <34 weeks
      - Systollic - < 140
    - - bed rest (lie to lateral side)
      - PE chart: BP, proteinuria, fetus CTG, doppler
      - mom and fetal vital sign
      - anti hpt drug: methyldopa, labetolol, nifedipine, hydralazine