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The Diagnosis criteria for Pre-eclampsia
• The Diagnosis criteria for Pre-eclampsia based on the ACOG guidelines and the maternal and fetal complications related. Discuss the Diagnosis criteria for Pre-eclampsia based on the ACOG guidelines and the maternal and fetal complications related.
• C.C is a 36-year-old female patient known in the office who came to consult you because she has been feeling left breast tenderness, low grade fever and malaise for about four days. She delivered her baby 3 months ago and is breastfeeding. You found the left breast warm and painful when examined. Fissures on nipples presented. List your diagnosis and support. • If infection is suspected which bacteria are usually involve in this process. • Discuss a management plan for C.C (pharmacologic and non-pharmacologic treatment). • List patient’s education and recommendations
Full Answer Section
Impaired liver function: Elevated blood concentrations of liver transaminases 1 to at least twice the upper limit of normal.
Patient's symptoms: Left breast tenderness, low-grade fever, malaise, 4-day duration.
Physical exam findings: Warm and painful left breast, nipple fissures.
The patient is postpartum, and breastfeeding, which are major risk factors.
3. Common Bacteria in Mastitis
Staphylococcus aureus (most common).
Staphylococcus epidermidis
Streptococcus species.
Less commonly, Escherichia coli.
4. Management Plan for C.C.
Pharmacological Treatment:
Antibiotics: A course of antibiotics that are safe for breastfeeding. Common choices include dicloxacillin, cephalexin, or clindamycin.
Pain management: Analgesics such as ibuprofen or acetaminophen.
Non-Pharmacological Treatment:
Frequent and effective breast emptying: Encourage continued breastfeeding or pumping every 2-3 hours.
Warm compresses: Apply warm compresses to the affected breast for 15-20 minutes several times a day.
Rest: Encourage adequate rest.
Proper latching techniques should be reviewed.
If an abcess is suspected, an ultrasound should be performed, and drainage performed if needed.
5. Patient Education and Recommendations
Importance of completing the full course of antibiotics.
Proper breastfeeding techniques: Ensure proper latch and positioning to prevent nipple trauma.
Frequent breast emptying: Emphasize the importance of frequent and complete breast emptying to prevent milk stasis.
Hygiene: Maintain good hand hygiene and breast hygiene.
Rest: Encourage adequate rest to promote healing.
Hydration: Drink plenty of fluids.
Pain management: Explain how to use analgesics safely and effectively.
Explain the signs and symptoms of worsening infection, and when to seek medical care.
Explain the importance of follow up care.
Sample Answer
Absolutely, let's break down these obstetrical and postpartum care scenarios.
1. Pre-eclampsia Diagnosis and Complications (ACOG Guidelines)
Diagnosis Criteria (ACOG 2019):
Hypertension: Blood pressure ≥140/90 mmHg on two occasions, at least 4 hours apart, after 20 weeks of gestation in a previously normotensive woman.
Plus ONE of the following:
Proteinuria: ≥300 mg in a 24-hour urine collection or a protein/creatinine ratio ≥0.3, or a dipstick reading of ≥+1 (if quantitative measurements are unavailable).
Thrombocytopenia: Platelet count <100,000/µL.
Renal insufficiency: Serum creatinine >1.1 mg/dL or a doubling of the serum creatinine concentration in the absence of other renal disease