Dan Sutherland picked up the notes. ‘Does she have many risk factors for pre-eclampsia?’
‘A few.’ Luca raked long fingers through his dark hair. ‘First baby, overweight, family history according to the case officer—her mother had pre-eclampsia—and her blood pressure was already high.’
Dan frowned. ‘How do we know that?’
‘The casualty officer rang the GP to check on her history.’
Dan raised his eyebrows in surprise. ‘Smart chap.’
Luca gave a wry smile. ‘It was a woman,’ he drawled softly, his eyes flickering back to the notes. ‘She called me down to A and E because she was worried, I examined the patient and gave her a nifedipine capsule to chew because we needed something fast-acting. In my opinion she was—and is—at very high risk of developing full-blown eclampsia.’
Dan nodded. ‘All right, let’s take a look at her. She’s going to need one-to-one care, I should think.’
‘Tia will be her midwife,’ Sharon said quickly, pushing open the door and holding it while they all trooped into the room.
‘Hello, Sue, I’m Dan Sutherland, the consultant and this is Dr Zattoni, my senior registrar, and Dr Ford…’ Dan made the introductions as Sue Gibbs lay on the bed, clearly very ill. ‘And you had no idea you were pregnant?’
Sue shook her head, slowly. ‘None. My husband and I were desperate to have a baby, but in the end nothing happened so we gave up. I still can’t believe I’m pregnant. Are you absolutely sure?’
Dan gave a brief nod. ‘But it seems that you’ve developed a condition called pre-eclampsia, Sue. Which is basically high blood pressure of pregnancy. It can be dangerous if not controlled, so we’re trying to bring your blood pressure down.’
‘Will the baby be all right?’
‘Don’t worry about the baby,’ Dan said immediately. ‘The scan shows us that at the moment he’s fine. His heartbeat is strong and he’s still moving around. It’s you we need to worry about.’
He motioned to Tia to take over with the patient and moved to one side with Luca.
‘We need to give her an anti-hypertensive by infusion, do you agree?’
Luca nodded. ‘And we need to catheterise her and monitor her output.’
Dan cast another look at the patient and then lowered his voice. ‘I suggest you stay close.’
Luca nodded, understanding immediately. ‘That was my intention.’ He turned to Dr Ford. ‘I want you to check U and Es, LFTs, urate and placental function and platelets. A falling platelet count and changes in clotting factors have been reported in many cases of pre-eclampsia. Tia, can you put her on a monitor and keep her on it for now?’
Tia nodded. It was obvious that they were very worried about Sue.
She monitored Sue’s blood pressure regularly throughout the morning but despite the drugs it still crept upwards.
She slipped out of the room briefly to have a word with Luca, who was at the desk finishing a telephone call, Dr Ford by his side.
‘Her blood pressure is sneaking up again,’ she mouthed, and he nodded as he replaced the receiver.
‘She is at a very high risk of developing full-blown eclampsia,’ he agreed and Dr Ford frowned.
‘But you’ve given her anti-hypertensives.’
‘Anti-hypertensives do not alter the course of pre-eclampsia,’ Luca reminded her. ‘There is only one thing that will do that, which is?’
He paused, waiting for Dr Ford to answer, but she looked at him blankly.
‘Delivery.’ Tia broke the awkward silence, thinking that if the glamorous Dr Ford paid as much attention to her textbooks as she did to her make-up and her male colleagues, she might be a better doctor.
‘Yes.’ There was a warmth in Luca’s eyes as they rested on her briefly and then he turned his attention back to his SHO. ‘I’d like you to bleep Duncan Fraser, the anaesthetist, and warn him that we might need his services at short notice, and do the same with Paeds, please. I think we’re probably going to need to get the baby out. And could you also call ITU and check their bed state?’
Dr Ford reached for the phone, her expression flustered for the first time.
Tia followed Luca back to the room.