The Patient I Took Care Of Was A 30-35 Year Old Female

The onset of her labor was on a Saturday morning. She thought she had had too many tacos, but then she lost her mucus plug. Labor was slow because her cervix would not dilate. She went to the hospital more than once, but the maternity ward would not admit her because her cervix was stuck at two centimeters. The obstetrics staff advised her to walk around which she did. She took multiple hot baths to help with the pain. She was in labor and awake on and off from Saturday morning until Monday night when she finally gave birth at Kaiser hospital in Riverside, California.

This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks

I protected Laura’s perineum with warm compress and applied pressure to Ollie’s head while coaching Laura to pant. Laura and I worked together to slowly deliver his head and achieved and intact perineum. This is a skill that I have successfully worked on and developed. When I began working with Laura’s midwife at the beginning of the year I was still unsure of how to properly protect the perineum and how much pressure to apply if being hands on. Following the delivery of Ollie’s head I asked the backup midwife to lower the head of the bed to allow more room for Ollie’s shoulders. Dave was standing patiently at the side of the bed, gloved up and chanting Laura on. Once Ollie’s shoulders were delivered Dave helped with the rest of his body. We dried Ollie down and then Dave placed him up on Laura’s chest for skin-to –skin with a clean, dry, warm towel covering the two of them. The back-up had drawn up syntocinon for the third stage and had said she would administer it. I would manage Laura’s third stage because she had been induced, had a precipitious delivery, and Ollie was a large baby over 4.5kgs (Pairman et al, 2015 – pg 1141; stables pg 607; McKenzie, 2013; Goddman, Nathan & Chazotte, 2016; Sheldon et al 2014). However the backup delayed the administration of the syntocinon in hope to protect a physiological third stage.

This letter is to confirm Carrie Yale is a patient of ours at Emory Gynecology and Obstetrics. She delivered on 2/7/16 via C-section and was admitted from 2/7/16- 2/10/16. On 3/4/16 she was reevaluated and is experiencing severe headaches and pain around her C-section incision. Because of this she is not released to return to work until 4/4/16. We have referred her to Emory Neurology to evaluate the headaches. She may return on 4/4/16 without restrictions.

By dates, she is 14 6/7 weeks and the measurements overall are concordant. The amniotic fluid volume is normal and the cervix is long and closed with no evidence of membrane funneling. An overview fetal assessment was performed and no gross malformations were noted. A detailed anatomy assessment was not performed due to the early gestational age.

Mary is a 28yo, G1 P0, who was seen for a follow-up ultrasound assessment for fetal viability. As you know, her pregnancy is complicated by a fetus with multiple anomalies including heterotaxy, an AVSD, fibroelastosis of the ventricle musculature, complete heart block, and hydrops. On today’s evaluation overall, the patient has no obstetrical complaints and still does have positive fetal movement. On arrival her BP was 134/90 and her urine was trace protein. Recheck of her BP about 5 minutes later was 130/88. She has gained 5 lb in the past 2 weeks but denies headaches, blurred vision, or any signs of preeclampsia. We did obtain lab work today and will forward these to your office upon return.

HPI: YM is a 24 year old G2P1 who presents for New OB Visit at 28 weeks 6 days. Her concerns are the following:

Heather is a 39yo, primigravida, who is currently 25 weeks 4 days. She is AMA and declined aneuploidy screening. She did have a normal anatomic survey. She is obese and has a history of uterine polyps but is otherwise healthy. Last night she presented to Labor and Delivery triage with vaginal bleeding that started unexpectantly. She reports that she had some increased activity with discomfort the night prior but by the morning it had resolved. She was at work and without any precipitation noted the bleeding. She did have some right-sided burning that she assumed was round ligament pain associated with it. The bleeding was noted in her underwear and then with wiping. She reports that while in triage a speculum exam removed a darker red clot. They checked her cervix and she was not dilated. She noted herself that the bleeding had resolved. They offered her admission for betamethasone due to the unexplained cause of bleeding but she declined. She is here today for ultrasound and evaluation.

Previous trauma to the cervix, such as a D&C (dilation and curettage) from a termination or a miscarriage

First, I would anticipate the provider will transfer Elinah to L & D unit because the assessment finding reveals that she is experiencing preterm labor. Second, I would anticipate that the provider will order some medication like betamethasone, magnesium sulfate, indomethacin to slow or delay the contraction from occurring. In addition, I would anticipate the provider will order lab works such a complete blood count to detect infection, urinalysis to see if Elinah has active infection and an amniotic fluid analysis to determine fetal lung maturity and the presence of subclinical chorioamnionitis, ultrasound test to see the viability of the fetus and fetal fibronectin testing to see if the membrane has ruptured and if it is ruptured. According

A clinical issue, observed while on placement include the lack of consistency in the approach for pushing during the second stage of labour and the high level of perineal trauma.

Patient Y herself did not exhibit any signs or symptoms that the fetus was in distress while in the labor room. She did state after the C-section that she was experiencing decreased fetal movement for the past few days, but did not think

In March 2015, Lawal mistakenly removed a patient’s fallopian tube and ovary during an operation to remove her appendix.

Due to foetal distress, a first-time mother has given birth via caesarean section. Baby was well and didn’t receive resuscitation or admission to special care nursery, however baby