Case Report On The Emergency Room

2205 Words Jul 24th, 2015 9 Pages
Case Report A 22-year Caucasian female Jehovah’s Witness, 28 week pregnant came to the emergency room in Australia, with a history of fever for 1 week, fatigue, extensive bruising, nose and gum bleeding. The patient was pregnant with her third child, and had 2 other children aged 2 and 4 years at home. The patient worked in the bank and was the primary breadwinner of the family as her husband was disabled after a motor vehicle accident and could not work. Laboratory tests revealed a white blood cell count of 76.2 × 103/mm3 (very high), hemoglobin 3.6 g/dl (very low) and platelets 6 × 103/µl (very low). A bone marrow biopsy confirmed the diagnosis of leukemia. The patient was accepting of all treatment options except for blood transfusion. Multiple physicians explained to the patient that her hemoglobin was very low and that it could result in the loss of the fetus if the hemoglobin level was not increased immediately by means of a blood transfusion. It was also explained to the patient that leukemia in pregnancy had a very good prognosis with 83% going into remission with chemotherapy, but the patient had to undergo blood transfusions to increase hemoglobin and blood counts. The patient had a very high risk of death, if chemotherapy were started in the presence of low blood counts, as chemotherapy would further decrease the same. Patient was also advised that the baby would have to be delivered by caesarian section in the event of fetal distress, which was highly…
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