Oxford Handbook of Midwifery (96 page)

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Authors: Janet Medforth,Sue Battersby,Maggie Evans,Beverley Marsh,Angela Walker

BOOK: Oxford Handbook of Midwifery
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428
CHAPTER 19
Emergencies
Table 19.4
Blood chemistry valves in pregnancy: detecting deviations from normal

 

Test Non-pregnant
Pregnancy
PIH/PET
DIC Notes
Causes of abnormal result
Biochemistry
Sodium (mmol/L
–1
) 132–144
132–144

– Fall to lower end of non-
Low sodium in
pregnant range. Body
hyperemesis
sodium increases in
pregnancy but levels
unchanged due to water
retention
Potassium (mmol/L
–1
) 3.6–5.1
3.6–5.1
May (i)
– Raised levels represent
PIH, HELLP, primary renal
deterioration of renal
disease.
function
Urea (mmol/L
–1
) 4.3 (2.5–6.6)
2.3–4.3
(i)
– Normally d due to
PIH, HELLP, primary renal
increased renal blood flow.
disease
Raised levels represent
deterioration of renal
function
Creatinine (μmol/L
–1
) 73 (55–150)
50–73
(i)

Chloride (mmol/L
–1
) 95–107
95–107


Uric acid (mmol/L
–1
) 0.2–0.35
0.15–0.35
(i)
– Raised levels represent
PIH, HELLP, primary renal
deterioration of renal
disease.
function
429
BLOOD TESTS RESULTS DURING PREGNANCY

Test
Non-pregnant
Pregnancy
PIH/PET
DIC
Notes
Causes of abnormal result
Liver function tests
Total protein (g/L
–1
)
78 (60–80)
70
(d) to (d d)

Normally just below non-
PIH, HELLP
pregnant reference range.
Increased loss of protein
and decreased production
due to liver dysfunction in
PIH/HELLP
Albumin (g/L
–1
)
45 (36–47)
33
(d) to (d d)

ALT (U/L
–1
)
10–40
10–40
May (i)

Raised levels indicate
PIH, HELLP, primary liver
hepatic cellular damage.
disease
Levels slightly i post
partum
AST (U/L
–1
)
10–35
10–35
May (i)

G-glutamyl transpeptidase (U/L
–1
)
7–50
7–50


No significant change
Alcohol abuse. enzyme- inducing drugs such as
barbiturates and warfarin

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