CASE PRESENTATION ON Dr.

Mohammed Sanwar Hussain

Intern Doctor

PREECLAMPSIA WITH OBESITY Gynae Unit_3

SOMCH
 Patient’s profile
Name:Mrs.Rumi
Address : Shamer Kuna,Moulovibazar
Birthday: September 1992
Age: 26 years old
Birthplace: shamer kuna,moulovibazar
Height: 5f 2inch weight: 100kg
BMI: 40.3 kg/m2 (Obese Class III) Religion:Islam

Occupation: Housewife
Husband Name: Md.sufian
Date of Admission: January 18th , 2019
Time of Admission: 5:30 pm
Chief Complaints with Duration:
 Amenorrhoea for 36 weeks
 Swelling of the legs for 15 days

History of present illness :

According to statement she is amenorrhoeic for about 36 weeks .15 days prior to
her admission she noticed swellings of lower limbs

History of past illness:

Nothing contributory

Family History :
Her mother has anxiety disorder

Drug History:
None except for taking paracetamol for fever on her 6 months of pregnancy
Socio economic History : Lower Middle class
Obstetric History
Married for 3 years
2nd gravida with previous stillbirth
Menstrual history
Menarche at the age of 14 years
MP 3-4 days
MC 28-30 days
LMP Unknown
E.D.D Unknown
contraceptive history:
She was on oral contraceptive pill for 1 year following marriage and discontinued for
few months prior to conception.
Physical examination
general examination
 Appearance-healthy looking
 Body build:Obese
 Height:5 feet
 Aneamia:Mildly aneamic
 Jaundice:Nil
 Edema:Moderate
 Pulse:80bpm
 Bp:170/100mmhg
 Heart: nothing abnormality detected
 Lungs:clear
Abdominal examination
Inspection:
Abdomen is enlarged ,the uterus is elliptical in shape.striae gravidarum was
present.the umbilicus was central and flat

Palpation:
 Height of the uterus is of 36 weeks size,which corresponds to the period of
amenorrhoea
 Fundal grip-broad,irregular,soft breech is felt
 Lateral grip-the back is felt on the left side andirregular limbs on the right
side
 First pelvic grip:smooth,hard,smaller,ballotable head felt in the lower uterine
segment,the head is not engaged
 Second pelvic grip:the head is not engaged
Auscultation:
Foetal movement was absent,Foetal heart sound was inaudible by
both stethoscope and portable doppler

Per vaginal examination:

The patient was not in labor
Salient feature:
Mrs Rumi,26 years old,2nd gravida has been admitted at her 36 weeks of gestation
with the complaints of leg swellings for week and raised blood pressure for 3
days.she is also not getting any fetal movement for last few hours.
Her urine output is normal and she has no complaints about headache,visual
disturbance or epigastric pain.on general examination she is mildly aneamic,ankle
edema is moderate and blood pressure is 170/100 mmHg.On abdominal
examination,height of the uterus is of 36 weeks size which corresponds to the
period of amenorrohea .presentation is vertex,head is not engaged,liquor volume is
adequate.Blood group is B positive
INVESTIGATIONS:
HB% ESTIMATION
BLOOD GROUPING AND RH TYPING
VDRL
USG OF PREGNANCY PROFILE
Diagnosis:
2nd gravida with 36weeks of pregnancy with
severe preeclampsia with obesity