A 40 years old lady is 32nd weeks pregnant Gravid 3rd Para 1 | Figure 1

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Case Report

A 40 years old lady is 32nd weeks pregnant. Gravid 3rd Para 1 Abortion 2. She had SOBE, Orthopnea, Chest tightness for 1 month. Recently she can't lay down due to severe breathlessness. Then she was admitted to nearby hospital. After admission Hb% 7.3 gm/dl, then she was given IV Iron Sucrose; later her condition worsened. Later she was transfused 1 unit of Packed Cell. After transfusion her Hb% 6.7 gm/dl, S. Albumin 2.9 gm, Echocardiography Mild Pulmonary Hypertension with LVEF 60%, Hb Electrophoresis Normal, S. Ferritin 547. Then 2nd unit of Blood Transfusion was given, and after 1 day she had very high-grade fever and basal creps. She developed Ana sarca. Her condition is worsening. JAK2 Mutation Assay is sent, Vitamin B12 and Folic Acid level sent, Urine for Bence Jones Protein and Urine C/S sent. What is the next plan to save mother and baby?

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Conclusion: The next clinical steps involve careful monitoring and further evaluation of the mother and fetus's health given the deteriorating condition.