24 F primi gravida with fever

 A 24 year old female who is a primi gravida housewife by occupation, resident of nalgonda came  to opd with the chief complaints of

•  Fever since 4 days

•  Suprapubic pain 4 days back

• Vomitings  since 2days




HISTORY OF PRESENT ILLNESS -



The patient was apparently asymptotic 4 days back then She developed fever which was insidious in onset, intermittent in nature and is of high grade which was  assosiated with chills and rigors, and  subsided on medication.



First she went to government hospital for antenatal checkup, after 3 days she developed fever and went to  government hospital on the same day and  diagnosed  positive for ns1 antigen (dengue positive). The doctors over there referred her to our hospital.



She had a h/o  suprapubic pain after voiding 4 days back , which was of dragging type, and it has gradually decreased in its intensity, but she complains of slight bursts of pain sometimes.



She also complained of vomitings - 2episodes/day immediately after consumption of food containing food particles which was non bilious,non projectile, non foul smelling and non blood stained.



C/o of Burining micturition



She no h/o loose stools, rash, hematuria, malena 


PAST HISTORY -


She is not a known case of diabetes, hypertension,asthma,cad,epilepsy,tb.


PERSONAL HISTORY -



Diet-mixed  


Apetite -normal  


Bowel and bladder movements -normal 


Sleep - adequate 


Addictions -none 




FAMILY HISTORY -


Not significant 


MENSTRUAL HISTORY- 


Age of menarche -16 years 


Cycles- regular 3/28 


Pads used per day -3 


Pain,Bleeding,Clotting- absent 



MARITAL HISTORY- 


Duration of married life - 1 and half year

Non consanguinous 


OBSTETRIC HISTORY -


LMP 15/2/22

EDD  22/11/22

SEDD 20/11/22

Gestational age - 28weeks 


T1 :

Conceived spontaneously 

UPT done after 5 days of missed periods

Folic acid taken

Early scan done

H/o vomiting relieved spontaneously 

No h/o radiation exposure,bleeding or spotting pv



T2 :

Quickening felt at 5th month 

TIFFA done

Iron calcium not taken regularly 

No h/o pain abd,tightening 

H/o occasional pedal oedema,receiving on rest 

No h/o UTI,headache,epigastric pain,blurring of vision. 


GENERAL EXAMINATION -



Patient is conscious, coherent and cooperative and well oriented to time, place and person.



moderately built and nourished.



Pallor-absent



Icterus-absent



Cyanosis-absent



Clubbing-absent



Lymphadenopathy - labsent



Edema-absent



VITALS -



Temperature- 98.6*F       


Bp- 150/100mm hg                


Pulse-78bpm


RR - 20cpm


SPO2 -98% at RA





SYSTEMIC EXAMINATION-



CVS- s1 s2 heard, no murmurs  


RS - BAE+ 


CNS - intact 


P/A - soft and non tender ,bowel sounds heard 


INVESTIGATIONS 

















PROVISIONAL DIAGNOSIS 


NS1 positive (Dengue fever)



TREATMENT - 


1. Inj. Cefotaxim /gm/IV/BD 


2. IVF. 10NS and 10RL - 75 to 100 ml/hr 


3. Strict IO charting 


4. Inj. Zofer 4mg/IV/TID 


5. Inj. Pan 40 mg iv/od 


6. BP/PR/RR/spO2 charting 


7. Tab. Paracetamol 650gm po/QID 


8. Inj. Pcm 





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