Besides mild urinary tract infection treated with
Furagin, the first half of current gestation was asymptomatic
and uncomplicated. She denied smoking tobacco,
drinking alcohol or using drugs, diet supplements or
herbs during this pregnancy. She also denied abdominal
trauma in the course of gestation. At 21 weeks of gestation,
she noticed asymptomatic elevation of blood pressure
(BP). The maximum BP was 140/100 mm Hg and
no medication was administered. At 28 weeks of gestation,
the BP increased up to 150/100 mm Hg and the
ambulatory ultrasound revealed signs of fetal growth
restriction (IUGR). The Doppler examination demonstrated
elevated resistance and notching in both uterine
arteries. Fetal anatomy was normal. At 29 weeks of pregnancy
the patient was hospitalized in our Department for
the first time, because of mild hypertension and lower
limbs and face edema. She didn’t report any other symptoms.
Obstetrical examination did not indicate any pathologies
and the CTG tracings were reassuring. Results of
blood laboratory tests suggested no liver or kidney pathology.
The total protein in urine was an equivalent of
1+ on dipstick test. On ultrasound, the estimated fetal
weight (EFW) using Hadlock formula was 931 g, which
was below the 3rd percentile for gestational age. There
was elevated resistance to blood flow and periodic notching
in both uterine arteries. The biophysical profile was
8/8 points and the fetus’ presentation was cephalic. On
24-hour BP monitoring the mean BP values were 134
and 87.5 mm Hg for systolic and diastolic BP, respectively.
The maximum BP was 180/136 mm Hg. The BP
was normalized with methyldopa and patient was discharged
from the hospital. The therapy with methyldopa
was recommended, as well as BP monitoring 4 times
a day, counting fetal body movements and ambulatory
follow up in 7 days.
Besides mild urinary tract infection treated withFuragin, the first half of current gestation was asymptomaticand uncomplicated. She denied smoking tobacco,drinking alcohol or using drugs, diet supplements orherbs during this pregnancy. She also denied abdominaltrauma in the course of gestation. At 21 weeks of gestation,she noticed asymptomatic elevation of blood pressure(BP). The maximum BP was 140/100 mm Hg andno medication was administered. At 28 weeks of gestation,the BP increased up to 150/100 mm Hg and theambulatory ultrasound revealed signs of fetal growthrestriction (IUGR). The Doppler examination demonstratedelevated resistance and notching in both uterinearteries. Fetal anatomy was normal. At 29 weeks of pregnancythe patient was hospitalized in our Department forthe first time, because of mild hypertension and lowerlimbs and face edema. She didn’t report any other symptoms.Obstetrical examination did not indicate any pathologiesand the CTG tracings were reassuring. Results ofblood laboratory tests suggested no liver or kidney pathology.The total protein in urine was an equivalent of1+ on dipstick test. On ultrasound, the estimated fetalweight (EFW) using Hadlock formula was 931 g, whichwas below the 3rd percentile for gestational age. Therewas elevated resistance to blood flow and periodic notchingin both uterine arteries. The biophysical profile was8/8 points and the fetus’ presentation was cephalic. On24-hour BP monitoring the mean BP values were 134and 87.5 mm Hg for systolic and diastolic BP, respectively.The maximum BP was 180/136 mm Hg. The BPwas normalized with methyldopa and patient was dischargedfrom the hospital. The therapy with methyldopawas recommended, as well as BP monitoring 4 timesa day, counting fetal body movements and ambulatoryfollow up in 7 days.
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