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Cesarean Delivery: A Case Study

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Kristin is a 22yo, G2 P1001, who was seen for a follow-up ultrasound for interval growth and to further evaluate the fetal anatomy. She herself has type I osteogenesis imperfecta and has had many fractures in her lifetime. She also has a history of factor XIII deficiency and is followed by Dr. Hanna. She has had heavy bleeding in the past. Based on her height and weight at the start of the pregnancy, her BMI was 47 and currently it is about 49. She does have asthma that is currently asymptomatic. Her one previous delivery was by cesarean delivery and the plan will be to undergo a repeat cesarean delivery. Currently, at this time she has no complaints and has positive fetal movement.

By dates, she is 24 5/7 weeks and the measurements are concordant. The amniotic fluid volume is normal. A repeat fetal anatomy was performed and further views of the face and diaphragm were seen. Again, due to fetal position and maternal body habitus the fetal heart was not cleared.
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In addition, the plan will be to perform a repeat cesarean delivery at term. We have scheduled her to follow-up with us in 4 weeks for interval growth and to complete the fetal cardiac anatomy assessment. If we are unable to do that at the next visit we might consider getting a Pediatric Cardiology evaluation to clear the
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