James chats to Nhi Nguyen about common medical issues in pregnant patients.
Pregnant patients can be daunting for junior doctors for a number of reasons, the risk of missing something serious is a high burden of responsibility when there are two patients to consider, and the presentation may be caused by a medical problem unrelated to pregnancy or may be a specific pathology related to pregnancy.
Summary Writer: Jane McDonnell
Script Writer: Becky Taylor
Editor: Nhi Nguyen
Interviewee: Nhi Nguyen
Dr Nhi Nguyen is a Senior Staff Specialist in the Department of Intensive Care at Nepean Hospital in Sydney, Australia. She is also Clinical Advisor at Intensive Care NSW and at the Agency for Clinical Innovation. Nhi provides advice on the antenatal and peripartum management of pregnant patients with medical problems and has an interest in the critically ill obstetric patient.
With Dr Nhi Nguyen, Staff Specialist in Intensive Care at Nepean Hospital, New South Wales, Australia
Pregnant patients can be daunting for junior doctors for a number of reasons; the risk of missing something serious is a high burden of responsibility when there are two patients to consider, and the presentation may be caused by a medical problem unrelated to pregnancy or may be a specific pathology related to pregnancy.
A 30-year-old female presents to the Emergency Department with a 3-day history of shortness of breath with a pleuritic component and right upper quadrant pain. She is 32 weeks pregnant. This is her first pregnancy and she is well from an antenatal point of view with no significant medical problems.
If all investigations above are normal and you are considering a PE, what investigation is next?
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