Case of the Month #9 - pre-eclampsia

Published 03/02/2022

What is your differential diagnosis?

  • Pulmonary embolism  
    • (Leading cause of direct maternal deaths during or up to 6 weeks postpartum in the UK) 
  • Pre eclampsia  
  • Amniotic fluid embolism  
  • Haemorrhage – Including concealed e.g abruption, praevia, uterine rupture 
    • (Leading cause of maternal death worldwide) 
  • Cardiac disease  
    • (Leading cause of indirect maternal deaths in UK)
  • Sepsis  
  • Drug toxicity/overdose  
    • (Suicide is the leading cause of direct deaths occurring within a year of pregnancy in UK) 

On examination you find she is cool peripherally with increased capillary refill time. She has a tense, hard abdomen. A venous blood gas reveals Lactate 3.1, H+ 59, Hb 63.