User blog:Necator7/Dolores

Hi everyone!

Since I happen to be familiar with topic, I'd like to change this article. However, I dont' want to do it in too medical language.

''She becomes your patient when Rafael brings her in to the ER with smoke inhalation. It is later revealed that she had preeclampsia (characterized by high blood pressure in pregnancy), which is dangerous for the baby and would force her to give birth prematurely. She refuses to have a surgery due to the chance that her baby could die from being born too early and the preeclampsia progresses into eclampsia (seizures), resulting in her death. Her character model resembles Eliana Vera from The Senior.''

Uuuhh... that's a total pshaw. It's wrong in many ways.
 * 1) Dolores was brought to ER not only because of simple exposition to smoke inhaling, but exposition to smoke inhaling in pregnancy - it should be emphasized.
 * 2) You remember that Ethan ordered urine sample? You know why? Isolated hypertension in pregnancy isn't preeclampsia yet, it's just hypertension in pregnancy. Preeclampsia contains hypertension AND proteinuria in pregnancy.
 * 3) Preeeclampsia rarely evolves to eclampsia, but it may happen (mostly in "developing countries" of Africa, South America etc.). However, eclampsia is not isolated seizures, but the whole earlier preeclampsia symptoms AND seizures (combination: pregnancy+hypertension+proteinuria+seizures ). Isolated seizures in pregnancy may happen also in epilepsia or high fever in pregnancy.
 * 4) Cause of death in eclampsia is mostly the same as in other cases of hypertensive crisis - brain stroke, sometimes heart infarction.
 * 5) Treat for the baby and force her to deliver it... Not only. As you could see, preeclampsia and eclampsia is a threat for a pregnant woman in the first place, not only for a fetus. It Third World it's one of main causes of death in women during labour. I really don't know why Ethan, always being a smartass making unpleasant jokes about killing patients, didn't tell her off in some witty way: Your death won't help the baby, or It's better to be premature than orphan, etc. Maybe if he threatened her a bit, she would come to her senses and be saved? Blame the author...
 * 6) Dolores has some obsolete, XIX century theories about premature born children, that her baby could die from being born too early. She ignores the threat that baby could die in her belly even more likely. The article should notice it.
 * 7) If the illness in pregnancy is induced by pregnancy itself, causative treatment is ending this pregnancy. Though people in the book enigmatically call it delivering the baby, it's rather obvious that treatment of choice is caesarean section - you can imagine that it would be cruel to give her oxytocine and force the vaginal birth which would last for several hours, while she might die earlier.
 * 8) She refused "surgery". What surgery? Brain surgery? Cardiac surgery? There are many surgeries in gynaecology, but only this one in obstetrics - one and only "surgery" being "delivery" simultaneously . It's exactly caesarean section. Name of the procedure is important as much as name of disease, because it's too specific to be overlooked. Anonymous word "surgery" means all kind of operations.
 * 9) So there was a chance to save Dolores if she was operated in planned mode, while her life parameters were stable yet. In fact, mother's state affects fetus' state (stress hormons are going through placenta), so if Dolores' state was stable during the operation, her baby's state would be stable too (and he would had better chance to be alive and healthy).
 * 10) There are antihypertensive drugs allowed in pregnancy, there are also drugs preventing seizures, also allowed in pregnancy - not only patting patient's forearm and saying "come to your senses".
 * 11) Especially if she agreed to premedication, she would get steroid shot for baby's lungs maturing, what would strongly increase her baby's chances to survive.
 * 12) Operations in planned mode are more successful than these in emergency mode  - patients are usually prepared (empty stomach) and premedicated, and their life parameters are stable. Emergency patients often fave full stomach, their life parameters are often unsettled, and there's often no time to premedicate them, so it's a very risky operation.
 * 13) Due to her own stupidity and stubbornness, the operation was performed too late, in emergency, risky mode, with no premedication, what cost her life and baby's bad shape.
 * So, saying that Dolores "died in childbirth" is misleading. It's an obsolete XIX century term, meaning woman giving vaginal birth, screaming in pain and dying in the utmost torture - labor pain in the strongest pain for human, followed only by cancer pain. That atrocity didn't happen in this case. Dolores received caesarean section executed in emergency mode, she probably didn't feel pain being anesthesized (we're not monsters) and later unconscious, and actual cause of her death was a  brain stroke caused by eclampsia . It was chain of unfortunate events what killed her, not childbirth itself!

In these circumstances, I propose changes:

''She becomes your patient when Rafael brings her in to the ER after exposition to smoke inhalation in the 7th month of pregnancy. At first, she seems to be in a good shape and even flirts with Rafael and Ethan. Soon it's revealed that she has a preeclampsia - complication of pregnancy characterized by high blood pressure and proteinuria.''

''Since this state may be a threat for both mother and child, Ethan attempts to convince her to deliver the baby immediately through caesarean section. Dolores refuses, thinking that premature delivery would be more risky for the baby than her current state. Ethan dismisses you from her case, because your shift ended long ago.''

''Regardless of whether you decide to go out with Bryce or go to sleep in staff room, you lose her from your sight. Some time later you got a message on your pager that Dolores was taken to surgery. In the hospital you meet Ethan, who informs you that Dolores' state progressed into full eclampsia (symptoms of preeclampsia complicated by seizures) forcing doctors to deliver the baby in emergency mode. They managed to save the newborn, but Dolores didn't survive.''

Her character model resembles Eliana Vera from The Senior.

I'm awaiting your opinions.