Tag Archives: pregnancy

Case 87 – summary

This week we looked at a case of pulmonary embolism in a lady who was 28 weeks pregnant.   Initial management included: ABC ECG – T wave inversion. S1Q3T3 pattern and right bundle branch block.  May also help with identifying … Continue reading

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Case 87 – the beginning

A 32 year old lady presents to A&E with incresing shortness of breath and chest pain.  She is 28 weeks pregnant. What further information do you need? Initial management/investigations?

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Case 83 – summary

Many thanks to everyone who contributed to our case. This week the case centred on a pregnant female who was an obligate carrier of Haemophillia A (Her Father was affected). She had a factor VIII level of 54%. She was … Continue reading

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Case 83 – update 3 

Our pregnant patient had a factor VIII level of 54%. She is a carrier of intron 22 inversion as predicted from family history.  The free fetal DNA testing confirms she is carrying a male fetus. The patient has decided that … Continue reading

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Case 83 – update 2

Our pregnant patient returns to clinic she is now 13 weeks pregnant.  Her factor VIII level was 54%. She is a carrier of intron 22 inversion as predicted from family history.  The free fetal DNA testing confirms she is carrying … Continue reading

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Case 83 – update 1

After consideration of her family tree you realise  if there are no non-paternity issues she is an “obligate carrier” of Haemophillia A.  After counselling and discussion she agrees to having genetic testing for herself. She is willing to have free … Continue reading

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Case 83 – the beginning

You are in a joint obstetric haematology clinic and have been referred a 24 year old lady who is 13 weeks pregnant P0 G1 You take a family history and find her father and paternal uncle have severe Haemophillia A. … Continue reading

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Case 66 – summary

Thanks for all who have been involved in this week’s case.  We reviewed the causes of thrombocytosis in general and also applicable to pregnancy. Causes of thrombocytosis are usually reactive or secondary to another cause: Blood loss Infection/inflammation Malignancy Thrombopoietin … Continue reading

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Case 66 – update 3

Our patient is diagnosed with essential thrombocythaemia/thrombocytosis (JAK2 V617F positive) and is started on aspirin 75mg od.   At 28 weeks she has a painful swollen left leg. It is hot and tender. An ultrasound confirms a deep vein thrombosis. … Continue reading

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Case 66 – update 2

All reactive causes of thrombocytosis have been ruled out and our pregnant patient has a persistently elevated platelet count of 500×10*9/L. There is no history of VTE or miscarriage. There are no systemic symptoms such as weight loss, rash or … Continue reading

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Case 66 – update 1

Our pregnant patient with thrombocytosis has ferritin checked which is low at 17ug/l. Her CRP was also checked and it was <5ug/l. She is prescribed oral iron replacement – ferrous sulphate 300mg TDS and a FBC post iron replacement shows: … Continue reading

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Case 66 – the beginning

You are a GP and are reviewing blood tests that were taken during a booking appointment for a 29 year old who is 10 weeks into her first pregnancy. They show: Hb 100g/L (105-165) MCV 76fL (82-98fL) WCC 10×10*9/L (4-11) Neutrophils … Continue reading

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Case 58 – update 1

Thanks for the contributions so far.   We have established that our patient is a 37 year old female and has presented to her general practitioner with a swollen left leg. She had a recent car journey of 90 minutes … Continue reading

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Case 53 – summary

Lauren is a 34 year old woman with a postpartum acquired haemophilia. The presentation and diagnosis of this disorder has been discussed in the previous posts; the management is what concerns us at this point. The traditional approach to the … Continue reading

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Case 53 – update 2

Lauren, 34 had a baby 4 months ago and recently consulted her GP with marked easy bruising. Her GP did some blood tests which revealed a prolonged APTT at 69 seconds. The lab did extra tests to establish than rather … Continue reading

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Case 53 – update 1

Yesterday we met Lauren, a 34 year old who went to see her GP with easy bruising. She felt this was a new problem, although she mentioned her sister bruised easily. We explored this a little further. Her sister had … Continue reading

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Case 53 – the beginning

Welcome to the new case for the week. Please read the case, consider the questions posed and share your thoughts via twitter using #teamhaem @teamhaem. Lauren is a 34 year old woman who contacted her GP when she developed some … Continue reading

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Case 51 – summary

Thank you for all of your input this week. This week we looked at a patient who was diagnosed with AML in the 3rd trimester of pregnancy. She initially presented with a rash which, following a biopsy, was diagnosed as … Continue reading

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Case 51 – update 2

Our patient has been diagnosed with AML. FISH for t(15;17) is negative. The full cytogenetic report is awaited.  She is currently an inpatient and following discussion with the haematology, obstetric, neonatology and anaesthetic team she and the teams caring for … Continue reading

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Case 51 – update 1

So we have our first update. Our 20 year old lady who is now 32 weeks pregnant attended with a rash. This is her first pregnancy. She has been increasingly tired over the last 6 weeks, but has put this … Continue reading

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