Table 1 Characteristics of the patient
Characteristics | Reference value | At hospitalization | Before surgery | First day after CS | Second day after CS | Third day after CS | After 4 days from the onset | |
|---|---|---|---|---|---|---|---|---|
Clinical symptoms | General status | Unremarkable | Remarkable | Remarkable | Average | Altered | Deteriorated | Normal |
Blood pressure at maximum (mmHg) | < 140/90 | 200/100 | 160/90 | 154/105 | 118/77 | 131/86 | 128/88 | |
Pulse rate (bpm/min) | < 90 | 90 | 121 | 99 | 118 | 100 | 100 | |
Respiratory rate (beats/min) | < 18 | 23 | 20 | 25 | 29 | 20 | ||
SPO2 (%) | 95–100 | 93 | 94 | 98 | 88–92 | 98 | 99 | |
Body temperature (degree Celsius) | 36–37 | 37.0 | 37.0 | 36.5 | 37.0 | 37.1 | 37.0 | |
Symptoms | None. | Headache and epigastric pain. | Headache and epigastric pain. | -Gum hemorrhage -Subcutaneous hemorrhage on the right hand. | -Blurred vision -Tired. | -Confusional state. -No response to stimulation -Glassgow of 3 points. | Unremarkable. | |
Laboratory tests | PLT (109/L) | 172–378 | 41 | 46 | 214 | 203 | 180 | 201 |
Hemoglobin (g/L) | 108–164 | 126 | 132 | 93 | 89 | 86 | 95 | |
Hct (L/L) | 0.35–0.51 | 0.373 | 0.384 | 0.274 | 0.252 | 0.263 | 0.281 | |
WBC (109/L) | 3.37–8.38 | 15.06 | 13.07 | 21.46 | 22.7 | 17.2 | 12.49 | |
Neu (%) | 39.8–70.5 | 85.7 | 84.1 | 88.1 | 84.1 | 81.5 | 65.7 | |
AST (SGOT) (U/L) | < 35 | 1325 | - | 165.8 | 70.24 | - | - | |
ALT (SGPT) (U/L) | < 35 | 600 | - | 167.6 | 102.10 | - | 43.01 | |
Total bilirubin (µmol/L) | < 15 | 76.17 | - | 24.24 | 11.99 | - | 64.86 | |
Direct bilirubin (µmol/l) | < 5 | 34.86 | - | 9.19 | 7.80 | - | ||
Albumin (g/l) | 35–52 | 30.11 | - | - | 27.03 | 27.1 | 28.22 | |
Protid | 62.88 | |||||||
Na+ | 136–146 | 133.4 | - | 126 | 128.9 | 136 | 138.5 | |
K+ | 3.4–4.5 | 3.54 | - | 2.9 | 4.29 | 3.78 | 3.20 | |
Ca++ | 2.20–2.65 | 2.17 | - | 0.63 | 1.78 | 1.62 | 2.04 | |
Chlorid− | 101–109 | 100.7 | - | - | 95.9 | 103.8 | 102.9 | |
Mg++ | 0.77–1.03 | 2.17 | - | - | 2.88 | 2.30 | 0.66 | |
Management | Obstetric indication | Monitoring. | IOL and CS due to non-assuring FHR. | Postoperative follow-up at reanimation room. | Postoperative follow-up at reanimation room. | Postoperative follow-up at reanimation room. | Consultation with a neurologist and requiring a MRI. | Postoperative follow-up at ward. |
Medical treatment | -Anticonvulsive (MgSO4) -Antihypertensive (Nicardipine) -Antibiotic (cephotaxin, vinphacin) | -Anticonvulsive (MgSO4) -Antihypertensive (Nicardipine) -Antibiotic (cephotaxin, vinphacin) | -Anticonvulsive (MgSO4) -Antihypertensive (Nicardipine) -Antibiotic (cephotaxi, vinphacin) | -Anticonvulsive (MgSO4) -Antihypertensive (Nicardipine) -Antibiotic (cephotaxin, vinphacin) -Oxygen support via cannula | -Maintenance of Anticonvulsive -Antihypertensive -Antibiotic modification (imipenem, levofloxacin) - Oxygen support via cannula | -Antiepileptic therapy including haloperidol 2 mg twice a day and levetiracetam 500 mg twice a day. | -Antiepileptic Haloperidol 2 mg twice a day -Levetiracetam 500 mg twice a day | |