Cesarean Delivery: A Case Study

G4 P3003 (4 Gestations, 3 Full Term, 0 Preterm, 0 Miscarriages, 3 Currently Living); 3 Spontaneous Vaginal Deliveries; Last birth was 7 years ago by SVD, weighed 4000 grams; No previous obstetrical complications or morbidity; No past medical history; No past surgical history; No prior antenatal care

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.

Serrita is a 26yo, G3 P1011, who was seen for an ultrasound evaluation and fetal anatomy assessment. As you know, she has chronic HTN and is on methyldopa 500 mg b.i.d. Her BP is normal on today’s assessment at 130/78. Her urine evaluation was negative. She is also hypothyroid status-post a diagnosis of Hashimoto’s thyroiditis. She is on replacement therapy. She did undergo noninvasive prenatal testing (NIPT) that returned low-risk, female and her maternal serum AFP was normal at 0.58 MoM. Based on her height and weight at the start of the pregnancy, her BMI was about 38. Lastly, she is on metformin 500 mg b.i.d. She states that she believes that she was on this due to abnormal insulin levels but she was not completely certain as to why

On today’s evaluation, she is 13 6/7 weeks and the crown-rump length measurement is concordant. The nuchal translucency measurement fell within the normal range. The nasal bone was identified, and there was normal ductus flow.

Thank you for the opportunity to participate in the care of Ms. Stansberry, who as you know is a 15yo female, G1 P0, currently at 26 weeks 0 days EGA with a pregnancy complicated by late establishment of PNC and maternal obesity.

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

Joanne and Steve wanted a C-section as they had difficultly delivery with their first child; however Joanne went into labour early. The baby was delivered 3 days before the C-section was scheduled. With her first child she was given an epidural that did not work, this is why she had requested the C-section for the birth of this child. Their first child died at 21 days old, he was an IVF baby and it had taken them 5-6 years to get him. After a couple of years they started trying for another baby, they had been saving up for more IVF but they managed to conceive naturally. They had more scans during this pregnancy to ensure the health of the baby was okay.

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.

List the complications this newborn may have. Using assessment findings and OB history, explain why the complications may be present. LGA, hypotonic, nasal flaring, grunting, retractions, tachypnea, transient apnea, diminished breath sounds, lethargic, high-pitched cry, mottled skin and slight pallor: The newborn may be hypoglycemic d/t the mother having a hx of gestational diabetes and uncontrolled diabetes with this pregnancy IV. Newborn Labs: Mark the box corresponding to the patient’s lab level: low, WNL, or high. Give a rationale for abnormal labs.

We discussed the findings of today’s scan and the potential implications. I explained to them that neurologic abnormalities are a very difficult counseling sessions because it is impossible to determine outcomes. Even mildly dilated ventricles with no other associated findings can have significant delay. We discussed longterm consequences of both agenesis as well as Dandy-Walker given the findings on the ultrasound. We discussed their wishes in terms of continuation of pregnancy and to give us more information I opted to order a fetal MRI. This would likely be able to help us to determine the findings in the third and fourth ventricles and possibly even agenesis of the corpus callosum. We discussed the possibility of invasive testing with amniocentesis but they had previously done preimplantation genetic diagnosis and did not desire any further testing at this time. Finally, I spoke with Krystal about the implications of non-continuation of pregnancy and how the procedure is typically performed using laminaria in a 2-day process. For now, we will proceed with ordering the MRI and we will see her back in 4 weeks if she continues the pregnancy; otherwise, we will give her information for

Maternity Care and Delivery is a totally different situation that involves the health and well being of two patients, the mom and the baby. The procedures we code for would include the monitoring

She reported having a normal delivery, full term with no complications; developed normally. Major events: none. Nutrition history: fair. Social history: Currently lives with 2 children in her mother’s house, separated with ex-husband, who is in jail and plans to get a divorce.

Christine Le, an accountant living in Flushing, New York, gave birth to a healthy baby “Nathan” on January 29th, 2010. She found out that she was pregnant with her first child when her period was late. She had the routine prenatal care starting at 12 weeks and delivered at 40 weeks in a hospital with the present of her husband, Robert, and the in-laws. To insure her baby was healthy, Christine underwent several prenatal diagnostic methods like amniocentesis to examine for genetic defects. Another method was ultrasound; its purpose is to assess fetal age, multiple pregnancies, size and shape of the fetus. Christine underwent numerous lab tests to ensure that there are no complications (Berk, pg.43). Lab tests like a complete blood count that screens

I gave birth to my daughter on November 8, 2014. After 20 hours of labor, she failed to progress further and I

One of the most challenging stages of pregnancy can be the intrapartum period. This is the period were a women is birthing her child, although it may be really challenging it is also the most exciting part of pregnancy for most couples. Bridget is a twenty-eight year old multiparous women who is thirty-nine weeks and five days pregnant. Bridget has been admitted into the labour ward with antenatal history showing a normal physiological pregnancy and she has entered a spontaneous labour that is progressing well and all her maternal observations and fetal observations are within the normal range suggesting that she is unlikely to require any interventions during labour especially a caesarean