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PRESENTED BY:-
SUNIL PANDEY
KAMAL P. SAUD
INDRA K. GURUNG
ANANDA JHA
Question:-
A young lady who delivered 7 days back by
LSCS presented with fever, seizures followed
by right sided hemiplegia.
1) PUERPERAL SEPSIS
History of::::: prolonged labor / prolonged
rupture of membrane/ any chronic diseases
/ multiple vaginal examination during labor.
O/E ::::: increased pulse rate and
temperature/ copious and offensive lochial
discharge
2) CORTICAL VEIN THROMBOSIS
History of ::::: severe blood loss/ anemia /
prolonged labor/ history suggestive of
infection/ headache/ blurring of vision
O/E :::: anemia/ dehydration/
DIAGNOSIS
3. Post partum ischaemic stroke
History of :::: hypertension/ diabetes/ heart
diseases / anemia/ headache/ blurring of vision
Family history of coagulopathy
History of smoking and alcohol consumption
O/E :::::
4. Post partum eclampsia
History of ::::: edema/ hypertension/ proteinuria/
fits
O/E::::: abnormal wt. gain, edema, rise of BP
INVESTIGATIONS
1. Puerperal sepsis
- High vaginal and endocervical swab
- Clean catch mid stream urine
- Blood: TLC, DLC, Hb, Platelet
- Thick blood film for malarial parasite
- Blood culture
- Pelvic ultra sound
INVESTIGATIONS
4. Eclampsia
- Urine: Hyaline cast, epithelial cells, red cells,
protein
- Opthalmoscopy: Retinal edema,
constrictions of arterioles
- Blood: Serum urea, creatinine, platelets
- Liver function tests
TREATMENT OF CVT
1. General treatment
- Monitor vitals
- Fluids and electrolyte balance
- Nursing care
- Care of bowel and bladder
- Glucose and saline infusion: To maintain
hydration
- Blood transfusion: For anemia
TREATMENT OF CVT
2. Specific treatment
- Heparin inj. started as soon as possible,
changed to oral anticoagulants (warfarin)
after 5-7 days
- Anti epileptic drugs: Phenytoinfor fits
- Certain medicines (steroids, mannitol) are
given to reduce the brain swelling
THANK YOU