Ms. PS is a 24 yo G2P0100 at 32.4 weeks gestation
admitted for severe preeclampsia. She has a history of a classical
Cesarean Delivery at 24.2 in a pregnancy complicated by HELLP syndrome
with a subsequent neonatal demise. At admission, her fetal tracing had
a baseline of 135 with minimal variability, no accelerations, and no
decelerations 4 hours ago. She has received one dose of Betamethasone
for fetal lung maturity approximately 3 hours ago. Ultrasound reveals a
fetus with 4%ile growth and a lagging abdominal circumference. There
is absence of end-diastolic flow in the umbilical artery. She is
currently on magnesium sulfate at 2 g/hr, and has received one dose of
intravenous Labetolol, 20 mg, approximately two hours ago. Her current
blood pressure is 153/97, pulse 86, temperature 99.1, respirations 18,
O2 saturation is 96% on room air. Her deep tendon reflexes are 3+/4,
her lungs are clear, and she has had 250 ml of urine output in the last
4 hours. Her urinalysis reveals 3+ proteinuria. Her liver enzymes are
within normal limits and her platelets are 112. She presently denies
headache, visual changes, shortness of breath, chest pain, or right
upper quadrant pain. Below is her current fetal tracing:
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