Afton Case Study

She had an 8-week ultrasound that confirmed her dates. She now is 11 ½ weeks and is interested in a FTS. The nuchal translucency measurement fell within the normal range. The nasal bone was identified, and there was normal ductus flow. She therefore underwent laboratory testing and the complete result of this screen should be available in the next 4-7 days. If the result of this screen returns with decreased risks, we would recommend a good fetal anatomical survey between 18-22 weeks gestation.

Views today demonstrate a viable singleton fetus at 31 weeks 0 days in vertex presentation with an anterior placenta. Fetal biometry appears symmetric and corresponds with stated EDD falling at the 56%ile. Interval growth is noted; however, the growth percentage did trend down from the 80%ile to the 56%ile. Follow-up fetal anatomy visualized as normal or was previously documented as normal. Ductal velocity today measured at 69.2 cm/se, which falls within normal limits. AFI remains reassuring at 12.6 cm. BPP 8/8. Doppler studies are normal in value and wave form.

Views today demonstrate a viable singleton fetus at 12 weeks 2 days. Fetal crown-rump length measures 59.2 mm. The best nuchal translucency measurement obtained was 1.8 mm, and the nasal bone was visualized as present. Fetal cardiac activity is visualized. Due to early gestational age, fetal anatomy was not assessed, but 4 extremities are noted. Amniotic fluid and placental location are visualized as normal within limitations of early gestational age. Adnexa are suboptimally seen. No notching is seen on the uterine artery Doppler’s.

On ultrasound there is a live fetus in cephalic presentation. Fetal biometry is consistent with dates. On detailed survey we did note an ONTD that is suspected to be from the lumbar down to the sacral area. There was no skin covering the area and there was no clear evidence of meningomyocele but on transverse imaging of the spine they are significantly splayed. In the intracranial views we did see a lemon and banana sign. The ventricles were upper-normal and prominent, right at 1 cm with dangling choroids.

On ultrasound there is a live fetus in breech presentation. Fetal biometry is consistent with menstrual dates. A detailed anatomic survey was unremarkable but slightly suboptimal

On ultrasound there is a live fetus in cephalic presentation. Fetal biometry is consistent with dates. Measurements are around the mid-percentiles. A limited survey was unremarkable. AFI today is 23.5 cm. Umbilical

            Upon arrival to the emergency department Kristin complains of acute abdominal pain lasting three days with an 8/10 on the standard pain scale which indicates that some organ or organs in Kristin’s abdomen are not properly functioning. Her very high ranking of pain indicates to the nurse that she is in excruciating amount of pain and is very uncomfortable because something is wrong in her abdomen.  Secondly, Kristin’s weight gain despite of lack of appetite indicates there is an issue. Typically, with decreased in appetites, patients will lose weight because they are not eating enough calories. Following this statement her glucose fasting levels were tested and came back at 105 mg/dL which is in the normal range for females according to Mayo Clinic. Following her initial assessment, the physicians want to run more tests to diagnose her symptoms. Kristin’s

X.C., a 30 year old married Asian female who works in her family’s business. She is a non-smoker, she does not drink alcohol or use drugs. She lives with her husband and 4 year old son. She denies any history of abuse, and reports feeling safe at home. She also uses her seatbelt regularly. X.C. presents to the office today for a scheduled non-stress test for gestational diabetes. Her blood sugars have been well controlled with this pregnancy, by diet. She is a G2P1, with one previous vaginal delivery. EDC is 4/8/16. X.C. is currently having lower abdominal pain and pressure in her vaginal area that started 3 days ago. She is also c/o of constant, dull pain in her right upper quadrant (under her ribs). X.C. has tried drinking water, resting, and Tylenol for pain. These measures

The patient continues to be tearful, having problems dealing with her limitations at this time. MD will try to renew her Ultracet and Elavil

Based on this new information, what is your diagnosis for this patient? Has your diagnosis changed? (2 pts.)

Jessica is a 29yo, G2 P0010, who was seen for a follow-up ultrasound assessment. As you know, we have been following her for an abnormal fetal kidney on the left side versus agenesis. Currently on today’s assessment she has no complaints and has positive fetal movement. The patient also does have a history of chronic HTN and is on labetalol 100 mg b.i.d. Her BP was normal at 130/83, and her urine evaluation was negative. In addition, based on her height and weight at the start of the pregnancy, her BMI was 39.

On today’s evaluation, she is 18 weeks 6 days and the measurements are concordant. The amniotic fluid volume is normal, and the cervix is long and closed with no

Keri is a 27yo, G2 P1001, who is currently 8 weeks 5 days by certain LMP but her cycles are quite irregular. She has not had an ultrasound this pregnancy. She was sent to us for consultation regarding a history of anxiety and medication use of Klonopin and Lexapro. She has weaned off from Klonopin 1 mg b.i.d. to about ½ tab once daily. She is planning to wean completely off soon. She also has a history of eclampsia that developed in the postpartum period. She was 2-3 days postpartum when she woke up with blurry vision and a headache. She preceded to have a seizure and was admitted to the hospital for several days in the ICU. Sher did not have any complications leading up to that and does not have chronic HTN. She is here today to meet

The physician will go on vacation after today and he will be back for cases on 2/16/2017. Please review and advise.

9.38am now completely expanded mother re-enters 37deg birthing pool. Basic signs not taken. 10.03am Mother starts to push.Foetus heart rate checked at regular intervals. 10.39am Mother crumples and floats all through cognizance. She 's given oxygen, expelled from pool and emergency vehicle called. Fetal heart rate was not consoling.10.56am Ambulance arrives and is put on standby.