Divine Word Hospital

DEPARTMENT OF
OBSTETRICS AND GYNECOLOGY

SGD #4

Date of consult: December 16, 2020

SB, a 40 year-old G5P4 (4004), was referred to DWH ER from a local health center due to
elevated blood pressure. She has no known co-morbidities. Family medical history showed
Hypertension for both parents. She has a 4 pack-year smoking history but allegedly stopped
upon knowing she was pregnant. All her children were delivered via spontaneous vaginal
delivery by a traditional birth attendant at home with no feto-maternal complications. Her
last pregnancy was in 2013. She had her menarche at 14 years old with subsequent menses
occurring at regular monthly intervals, soaking 2-3 pads per day, and lasting 3-4 days. Her
last normal menstrual period was on April 15-17, 2020. She had 4 prenatal check ups at the
local health center where she had normal blood pressure except during her most recent
check up where BP was noted to be 160/100. At the time, patient experienced bouts of
headache prompting consult at the local health center.

At the ER, BP 170/110 HR 98 RR 20 Temp 37.1⁰C O2Sats 99%

Weight 76 kg Height 165 cm BMI 28.1

HEENT: normal

Chest: no murmur, normal rate and regular rhythm

Lungs: clear breath sounds

Abdomen:
Fundic height: 25 cm
Estimated fetal weight: 2.2 – 2.4 kg
L1 – breech, L2 – fetal back maternal right, L3 – cephalic, L4-not engaged
Fetal heart tone: 150 bpm, right lower quadrant
(+) uterine contractions every 5-7 min, mild to moderate, lasting for 30-40 seconds

Internal examination (after MgSO4 loading): normal external genitalia, parous vagina, cervix
2 cm dilated, 30% effaced, medium consistency, posterior, intact bag of water,
head at station -3

Ultrasound:
Single live intrauterine pregnancy, cephalic, with good cardiac and somatic activities, 35
weeks by composite aging
Placenta right anterior, high-lying, Grade 2
Normohydramnios (Amniotic fluid index 12)
Sonographic estimated fetal weight is appropriate for gestational age 2389g + 270g
(Hadlock)
Biophysical profile score 8/8
 Divine Word Hospital
DEPARTMENT OF
OBSTETRICS AND GYNECOLOGY

Laboratories done revealed platelet 162,000u/L, AST 45, ALT 31, LDH 552