Krystal Case Studies

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.

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.

Keia is a 31yo, G2 P0100, who is currently 9 weeks 6 days as dated by a 6-week scan that was off from her LMP. She has a history of an IUFD at 29 weeks. She reports that she had decreased fetal movement prior to coming in and there being no fetal heart tones on examination, but other than that there were no other significant precipitating events. She did have an increased risk for Down syndrome at 1:140 but per the old reports all of her analytes were within normal limits. At the time of delivery, the baby did appear to be appropriate weight and there were no obvious causes at the time of delivery. She reports that she had chromosomes performed after and the chromosomes were negative. She also thinks she had a full autopsy that was unremarkable. She did have a work-up for clotting disorders due to the history of loss and according to the chart everything is relatively within normal limits except for MTHFR which was heterozygous for C677T and A1298C. I did not see beta-2 glycoprotein or antithrombin III. Because of the relatively normal work-up she is on a baby aspirin and Metanx. She is here today to discuss her history and plans for this pregnancy.

She is without complaints. She has not noted any increase in preterm labor. No signs/symptoms or change in pelvic pressure. She is compliant with bedrest and has help taking care of her son. She is otherwise aware that she should discontinue Motrin next week and is aware of the signs/symptoms that we are monitoring. The placental cord insertion does appear marginal as noted on prior ultrasound and we are following monthly growth. She is aware that after surveillance of cervical length which will the last one we would anticipate would be next week at 32 weeks and after that we would still recommend monthly evaluation of fetal growth. Preterm labor precautions were reviewed. She is scheduled to return in one

It is our pleasure to see and perform FTS on Ms. Kaylyn Houser. She is a 16yo, G1 P0, with EDD by LMP consistent with an 8-week 4-day ultrasound performed in your office. The patient has a history of anxiety and what sounds like bipolar disorder, narcolepsy, and sleep apnea, as well as prepregnancy BMI of 32. She was previously on Lamictal, Luvox, and magnesium when she started the pregnancy and comes today attempting to wean from the Lamictal currently taking 100 mg daily. Her surgical history is notable for ankle surgeries. She has no prior pregnancy history. Her social history is negative x3. Her registration BP is 137/81. Her urine dip is negative for protein.

On today’s evaluation, she is 19 weeks and the fetal measurements overall are concordant. The long bone measurements are within one week of her dates. The amniotic fluid volume is normal, and the cervix is long and closed. A complete fetal anatomical survey was performed and a significant amount of ventriculomegaly/hydrocephalous was identified but no other major malformations were noted at this time, though due to the

Kecia is a 25yo, G3 P2002, who was seen for an ultrasound evaluation to evaluate the fetal abdomen. She overall denies any major medical disorders. She reportedly had a seizure related to an anesthesia event in a prior surgery but denies any history of epilepsy and therefore is not on an anticonvulsant. She has 2 previous term uncomplicated vaginal deliveries in 2012 and 2016. On today’s evaluation, overall, she has no obstetrical complaints and has positive fetal movement.

On ultrasound, there is a live fetus in breech presentation. Fetal biometry is symmetric and consistent with dates. A detailed anatomic survey was overall unremarkable but we were unable to adequately obtain fetal cardiac views in order to complete the echocardiogram. Both myself and the sonographer scanned and unfortunately the fetus remained in the spine up position after an extended amount of

By dates using an EDD of 05/02/17, she is 14 3/7 weeks. The fetal measurements on average are about 9-10 days larger and are symmetrical. The amniotic fluid volume is normal and the cervix appears to be long and closed. There is an anterior LUS fibroid that is about 2 ½ cm in size. A fetal anatomy assessment was performed though limited by the early gestational age. No major malformations were

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.

On ultrasound evaluation today a single living fetus is identified currently in cephalic presentation with a 3-vessel cord and an anterior placenta. Fetal biometry today is consistent with an EFW of 1386 g, which equates to the 20%ile for gestational age and a symmetric appearing growth pattern. The amniotic fluid volume is within

On ultrasound there is a live fetus whose biometry is consistent with 20 weeks 5 days. A detailed anatomic survey was unremarkable but spine and RVOT were suboptimal. The placenta is posterior. Abdominal cervical length is reassuring.

On ultrasound there is a live fetus in cephalic presentation. Fetal biometry is about 2 weeks behind dates. growth is now < 3%ile. Measurements are fairly symmetric. We again noted a small right arm that is flexed at the elbow and held tight against the humerus. There is a 2-vessel cord. Both MCA and

On ultrasound, there is a live fetus in cephalic presentation. Initial scanning noted a very large abdominal cyst that appeared to be compressing the thoracic cavity. Intracranial anatomy appeared normal. It was impossible to evaluate the spine and intraabdominal contents in the setting of this large intraabdominal cyst. Measurements for the cyst were 8.4 x 12.6 x 12.8 cm. It appeared to be simple in nature.

A female neonate born premature at 32 weeks gestation was consulted on. While in the neonatal intensive care unit she developed multiple infections illnesses including meningitis. Her head circumference was noted to be increasing rapidly and was greater than the 90th centile for her age. She had a Computed Tomography (CT) scan of the brain and was noted to have hydrocephalus. She was referred to neurosurgery for assistance with her management. On examination, her head circumference was 40cm, fontanelles tense and she had the sunsetting sign. She moved all four limbs equally but was very lethargic. Her gestational age at that time was 34 weeks. Her Magnetic Resonance Scan showed massive communicating hydrocephalus. Due to her prematurity the plan was to