MARY ANN APARI, a G1P0 29 years old, female, single from sitio Bangbangkag, Brgy. Balioeg, Ilocos Norte, first came in for Prenatal Check up on the third month of pregnancy (June 7, 2011) Laboratory work up showed that patient is type "O", slightly anemic, and with normal urinalysis. On the last week of June 2011, she came back for consultation due to headache, nape pain
MARY ANN APARI, a G1P0 29 years old, female, single from sitio Bangbangkag, Brgy. Balioeg, Ilocos Norte, first came in for Prenatal Check up on the third month of pregnancy (June 7, 2011) Laboratory work up showed that patient is type "O", slightly anemic, and with normal urinalysis. On the last week of June 2011, she came back for consultation due to headache, nape pain
MARY ANN APARI, a G1P0 29 years old, female, single from sitio Bangbangkag, Brgy. Balioeg, Ilocos Norte, first came in for Prenatal Check up on the third month of pregnancy (June 7, 2011) Laboratory work up showed that patient is type "O", slightly anemic, and with normal urinalysis. On the last week of June 2011, she came back for consultation due to headache, nape pain
NARRATIVE REPORT This is a case of MARY ANN APARI, a G1P0 29 years old, female, single from sitio Bangbangkag, Brgy. Balioeg, Banna Ilocos Norte. Patient first came in for Prenatal Check up on the third month of pregnancy (June 7, 2011). History showed that last menstrual period (LMP) was on March 10, 2011. Laboratory work up showed that patient is type O, slightly anemic, and with normal urinalysis. On the last week of June 2011, she came back for consultation due to headache, nape pain, dizziness, loss of appetite and body weakness. She was diagnosed as Hyperemesis Gravidarum and admitted for hydration. She was given D5LR 1 Liter infused in 18 hours, and given aluminum-magnesium hydroxide and multivitamins. She went home the following day in fair condition. She came for follow up checkup after 5 days, still with dizziness, headache and occasional epigastric pain. She was noted then to be pale looking. She was given multivitamins, aluminum-magnesium hydroxide and advised milk supplement. Record showed that she was confined in Mariano Marcos Memorial Hospital and Medical Center in Batac City last July 9-12, 2011 with a diagnosis of Hyperemesis Gravidarum. Ultrasound was done with normal result and age of gestation was noted then as 12 weeks,2 days and expected date of confinement (EDC) as January 21, 2012 (submitted to Municipal Health Office on November 8, 2011 checkup). The next prenatal check up in Banna, Municipal Health Office was on the fifth month of pregnancy (September 15, 2011) which was uneventful. First dose of tetanus toxoid was given and advised to continue taking multivitamins. The next prenatal check up was November 8, 2011, where second dose of tetanus toxoid was given. The prenatal check up on December 6. 2011 was uneventful. On January 6, 2011, she came for consultation due to fever and cough. Urinalysis showed pyuria. Co-amoxiclav 625mg 1 tablet three times a day was prescribed for one week and given Ferrous sulfate. She came back one week after (January 13, 2012) and apparently had no fever but did not take prescribed medicine for one day. Repeat urinalysis showed no improvement, still with pyuria. She was then prescribed with Cefuroxime 500mg one tablet two times a day, given Ferrous sulfate one tablet once a day and advised to increase fluid intake and to have another follow up check-up after one week. She was also advised by the Municipal Health Officer (MHO) to deliver in the hospital. Patient did not come back on the scheduled check up last January 20, 2012. Prepared by: REMEDIOS L. PERALTA, M.D. Municipal Health Officer