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Scholars International Journal of Obstetrics and Gynecology (SIJOG)
Volume-3 | Issue-07 | 175-177
Case Report
Status Epilepticus- An Atypical Presentation of Chorioamnionitis: A Case Report
Dr. Sadia Solaiman, Dr. Anupama Bondili
Published : July 28, 2020
DOI : 10.36348/sijog.2020.v03i07.004
Abstract
The objective of this clinical case report is to highlight an uncommon presentation of chorioamnionitis as status epilepticus, complicated by consumptive coagulopathy and recurrent hypoglycemia. A primigravida of 18 weeks gestation, presented to the Accident and emergency department via ambulance with seizures. She did not have any hand-held medical records. No history could be obtained as she is a visitor with no friends and family. She was disoriented with Glasgow coma scale of 10/15, random blood sugar of 1.8, blood pressure 88/58, pulse 130, and temperature 36.8°C. Scan showed an 18 weeks live fetus. She was having uncontrollable seizures even after her glucose was corrected. Patient was also started on magnesium sulphate and anti epileptic infusions. She was intubated and transferred to ICU. On vaginal examination smelly discharge was noticed. Patient was started on Broad spectrum antibiotics. Her WCC elevated to 23, other investigations like Liver function tests, urea & electrolytes and creatinine were normal. The next day patient aborted spontaneously and continued to be tachycardic, tachypneic and hyperthermic with labs showing a picture of consumptive coagulopathy. Urine, blood culture and CSF cultures were normal. After Inotropes, antiepileptic’s, platelet transfusion, broad spectrum antibiotics, and appropriate fluid management, patient’s condition improved. Placental histopathology confirmed chorioamnionitis. She required ventilator support for 13 days. She suffered with recurrent episodes of hypoglycemia even after her sepsis was resolved which was treated by dextrose infusion and steroids and resolved spontaneously. She was discharged on 44th day of her hospital stay in stable condition.
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