Nursing Case Study On Fetal Fractions

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

Edward’s Syndrome is the second most common of the trisomy disorders, following Trisomy 21 (Down syndrome), but does not happen very often in developing fetuses. It occurs once in every 5,000 live-born infants, and most of these infants are female. Many times, the fetus that is affected with this disorder will not make it the full nine months. Other times, if the infant is born with the disorder they will only live for about a month or less. This disorder is seen more often when older women are pregnant, rather than young mothers. 10 percent of individuals with trisomy 18 will live past the first month, and some can even live into their twenties with severe developmental conditions and disabilities. The actual

This week of maternity clinical rotation, I had a patient Mrs. M was 35-year-old G2P2. She gave birth to a boy by cesarean section at 41 weeks. Mrs. M had Rh+ and Blood group was O+. She was rubella immune, +PPD and had no known allergies. Her GBS, HBsAg, and RPR status were negative.

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.

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.

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

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.

Ann mother went through a problematic pregnancy with her because she had oligohydramnios, which is Low amniotic fluid. Her mother wasn’t developing enough fluids. She was informed by doctors that Ann might have some major disability problems, such as down- syndrome. She had to keep going to different doctors for checkups. When it was time for deliver, Ann mother had

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.

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.

This paper is about the information from AAR. AAR is 38 years old, living and working in the surrounding Danville, PA area. AAR works for finance with an associate’s degree. AAR and her husband, PAR, are expecting their fourth child. AAR is gravida four, term three, preterm zero, abortion zero, and has three living children. With a last menstrual period of June eighteenth, AAR is fourteen weeks and five days and her estimated

Brittany is a 22yo, G5 P3013, who is currently 32 weeks 5 days. She is followed in the High Risk Obstetrical Clinic secondary to a history of Subutex use. Notably, she has had appropriate growth but at her last scan 4 weeks ago the amniotic fluid was low-normal at 8.2 cm. She is attempting to wean her Subutex and is doing quite well. She has had some decreased fetal movement recently, although she is able to obtain movement counts. She also complained of some possible leaking. She has not had any large gushes but has noticed that she needs to wear a pad throughout the day due to potential leaking.

Anliet is a 38yo, G10 P1081, who is currently 7 weeks 2 days. She has a history of recurrent pregnancy loss, some of which she thought was related to low progesterone. She has also had several ectopics and 2 elective terminations. She did not report any history of work-up for her recurrent loss as they were not consecutives. She also had one full- term pregnancy on progesterone supplementation. At last week’s ultrasound, there was a very small sac that was off from LMP but there was some thought that it could be just a normal early pregnancy and she is here today for follow-up. HCG was only 1200 at the time and progesterone was somewhat low at 10.