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Also I should have added, I donīt believe thrombolysing a pregnant patient is simply a matter of "bad for the foetus but good for the mother". Yes, clearly it will have the potential to cause placental abruption or other types of APH which will certainly be bad for the foetus, but these conditions can also be catastrophic for the mother too. AF The Rockes <[log in to unmask]> wrote: I'm a bit disappointed that no-one so far has discussed what the husband (if there is one might want to happen. I imagine there must be some men out there who would wish to put the life of their wife before that of a 28-week foetus and equally, some who would not. If it was me in that situation, I might well decide that I wanted the medical team to proceed with thrombolysis and let the foetus take its chances. Cheers, Rocky. ----- Original Message ----- From: "JONES Lewis, Locum Consultant - A&E" To: "Laurence Rocke" Sent: Friday, November 12, 2004 1:22 PM Subject: Re: Case scenario Definitely not thrombolysis as likely to kill mother and baby I would give clexane & aspirin . I would take the risk of long transfer and loos of myocardium and transfer to angio centre. Not that it would be the end of the story with her needing heparin, clopidogrel and aspirin after PCI. Lewis -----Original Message----- From: Accident and Emergency Academic List [mailto:[log in to unmask]]On Behalf Of Hugo Poncia Sent: 12 November 2004 00:51 To: [log in to unmask] Subject: Case scenario Here's one for the list... 28yr old female, 28 weeks pregnant, collapses at home. She had seen a medical practitioner earlier in the day with 'indigestion'. Bystander CPR for 15 minutes, return of circulation after intubation, adrenaline and paramedic CPR. GCS of 3 on arrival but good fetal heart rate. Some slight respiratory effort, Pt BP 130/80, p130, good pO2. Mother not in labour. ECG shows massive anterolateral MI. No angioplasty available on site and a relatively long transfer time to the nearest centre that can. What would YOU do? Who would/wouldn't thrombolsyse, and why? Any anecdotal experience? Cheers, Hugo Poncia (Loc ED cons) This message has been categorized as "Legitimate" by Bayesian Analyzer. If you do not agree, please click on the link below to train the Analyzer. http://10.1.15.239/bt/a.aspx?M=C:%5Csmtpmail%5CBayesTraining%5C2004-11-12%5C2dd6f89c76b9439ab41b15d5b5c64ac8&C=2 -- This email has been electronically scanned using DynaComm i:mail filtering software. If you have any questions please email [log in to unmask] Tony Daniel Sam Shayer Information Security Team