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Gestational Thrombocytopenia

A 26 YEAR FEMALE, G4P1L1A2 with 25 weeks 3 days GA with previous LSCS with ? Gestational Thrombocytopenia, ?ITP, ?APLA 

This is an online E log book to discuss our patient's de-identified health data shared after taking her guardian's signed informed consent. 

Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.This E-log also reflects my patient-centered online learning portfolio and your valuable inputs in the comment box are welcome.

CASE:


A 26 Year old Female, Housewife, G4 P1 L1 A2 with 25 weeks 3 days gestational age with previous LSCS.


Patient on regular checkup during pregnancy was found to have platelets 20,000 and was referred to our hospital.


HOPI:


No H/O Hematuria, Blood in stools, hematemesis, hemoptysis

T1- Spontaneous conception, h/o vomitings (subsided), no H/O Fever with rash, no H/O radiation exposure, white discharge, early Obs scan done

T2- Quickening present at 5th Month, TIFFA done at 7 weeks- normal 


LMP- 6/04/2022

EDD- 13/1/2023

SEDD- 7/1/2023 (9 weeks, 3 days)

POG- 25 weeks + 3 days


PAST HISTORY:

No H/O DM, HTN, ASTHMA, , CAD, Epilepsy, Bleeding disorders 

No H/O Drug Intake


PERSONAL HISTORY:

Diet - mixed

Appetite - Normal

Sleep - adequate

Bowel and bladder movements- Regular

No known allergies to drug and food

No addictions

Marital status - Married


MENSTRUAL HISTORY:

Menarche - 13years

3-5 Days/30 cycle

LMP- 6/04/2022

OBSTETRIC HISTORY :


Age at marriage- 18 Years

Age at first child birth- 20 Years

Gravida- 4

Para- 1

No. Of living children- 1

No. Of abortions- 2 at 6 weeks

GENERAL EXAMINATION:


After taking consent, the pateint was examined in a well lit room.


The patient is conscious, coherent, cooperative and we'll oriented to time, place and person.


She is thin built and moderately nourished.


No pallor, icterus, cyanosis, clubbing, lymphadenopathy, Edema, dehydration.


Temperature - Afebrile


Pulse - 80bpm 


Respiratory rate - 16cpm, regular


Blood pressure - 100/60 mmHg 


SpO2 - 99% at room air.


INVESTIGATIONS:


PROVISIONAL DIAGNOSIS:


A 26 YEAR FEMALE, G4P1L1A2 with 25 weeks 3 days GA with previous LSCS with ? Gestational Thrombocytopenia, ?ITP, ?APLA 




TREATMENT:


1. 1 SDP TRANSFUSION


2. Daily Fetal heart, Fetal movements count monitoring 


3. T. FERROUS ASCORBATE 100MG PO/BD


4. T. CALCIUM 1000MG PO/BD


5. T. ULTA MW 500MG PO/OD


6. T. MVT PO/OD


7. GRBS MONITORING 


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