CASE BASED LEARNING
CASE ;
A 35 YEARS OLD LADY IS BROUGHT IN ER IN COLLAPSED STATE. SHE HAS H/O
DELIVERY OF TWIN BABIES AT HOME 4 HOURS BACK. THIS WAS HER SIXTH
PREGNANCY. DURING HER PREGNANCY, SHE ONLY VISITED A LOCAL GP TWICE,
WHEN SHE WAS TOLD THAT SHE WAS ANAEMIC AND HYPERTENSIVE, BUT SHE
DID NOT TAKE ANY MEDICINES. SHE ALSO HAS H/O HEAVY BLEEDING AFTER LAST
BIRTH 2 YEARS BACK.
EXAMINATION
GENERAL:
SEMICONSCIOUS, SWEAT ON FOREHEAD, EXTREMITIES COLD, CLAMMY
PULSE; 140 B/MIN, FEEBLE
BLOOD PRESSURE; 80 / 40 MMHG
EXTREME PALLOR
ABDOMINAL:
SFH 26 CM
UTERUS FLABBY
VAGINAL:
HEAVY BLEEDING WITH CLOTS
UPON CATHETERIZATION:
20 CC DARK COLOURED URINE
INVESTIGATIONS
 COMPLETE BLOOD COUNT WITH HB 4 G/DL, PLATELET 121,300/MM3
 URINANALYSIS; NORMAL
 RBS 87 MG/DL
 LIVER FUNCTION TEST; NORMAL
 RENAL FUNCTION TEST; UREA 45MG/DL, CREATININE 1.1 MG/DL
 ELECTROLYTE, Na 138, K 3.4, Cl 102
 COAGULATION PROFILE; PT 16/12, 1NR 1.2, APTT 38/32