Wednesday, September 19, 2012

Phantom pregnancy

We had one patient came in to our casualty yesterday presented with sudden onset of right hemiparesis..
She is 40years old,gravida 6 para 5, 18weeks POA..
Claimed her last menstrual period was somewhere in may and already booked her pregnancy at klinik kesihatan..this is her first child from a second marriage.
Apart from sudden onset right hemiparesis, she has hx of chronic headache for more than 6 months..
On examination pt was comfortable. Vital signs were stable. All examinations are unremarkable. Her abdomen was to feel a mass at the abdomen at 14weeks size..
CAse was initially referred to o&g team to rule out eclampsia but was asked by o&g team to refer d case to medical team..
Patient was then planned for urgent cr brain to rule out intracranial bleed.
As pt is "pregnant", radiologist was a bit reluctant to accept the case eventho 2 specialists allowed her for ct scan..radiologist said that it was unlikely intracranial bleed and most likely space occupying lesion..she refused to do urgent ct brain and asked us to do it tomorrow during office hr..
As a part of examination, fetal assessment need to be done. O&g mo did an ultrasound in casualty when she didnt see anything per abdomen..
She thought that the machine migt b faulty so she asked the attendant to push patient to labour room whereby more reliaable ultrasound around..shee repeated an ultrasound and still found nothing..she did an urgent urine pregnancy test and guess whatt???
Shes not even pregnant!!!

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