You are asked to assess a woman who has given birth to her third child 2 hours ago. The baby was born at term, weighed 4.2kg, and was in good health. She had a natural delivery that lasted for 7 hours, and opted for a physiological third stage. According to the nurse, she has lost around 750ml of blood, but her vital signs are stable and the bleeding seems to be decreasing. What is the leading reason for her blood loss?
A 22-year-old woman who is 26 weeks pregnant comes to the emergency department complaining of severe headache and epigastric pain that has been worsening for the past 48 hours. Upon examination, she has a heart rate of 110 beats/min, a respiratory rate of 21 /min, a temperature of 36.8ºC, mild pitting oedema of the ankles, and brisk tendon reflexes. As pre-eclampsia is the likely diagnosis, what is the most crucial sign to look for?
A 32-year-old woman is 28 weeks pregnant and has had an uncomplicated pregnancy thus far. During her midwife appointment, glucose was detected in her urine and her fasting plasma glucose level was measured, resulting in a reading of 7.2mmol/L. What should be the next course of action in managing her condition?
A 31-year-old woman arrives at the obstetric department in the initial stages of labour. She is 36+4 weeks pregnant and has been experiencing polyhydramnios during this pregnancy. During examination, the foetal head is palpable on the right side of the maternal pelvis, while the buttocks are palpable on the left side. The amniotic sac remains intact. What is the best course of action for managing this patient?
A 27-year-old primigravida female comes in for a 36-week ultrasound scan and it is found that her baby is in the breech position. What should be done in this situation?
A 28-year-old woman who has never given birth is found to have gestational diabetes during her current pregnancy after an oral glucose tolerance test (OGTT). She inquires about the potential impact of this diagnosis on future pregnancies.
What is the recommended method for screening for gestational diabetes in subsequent pregnancies?
A 27-year-old G1P0 woman who is 32 weeks pregnant visits her GP with complaints of severe itching on her palms. She also reports feeling fatigued, which has been a persistent issue during her pregnancy. Upon examination, no rash is visible on her hands. Based on this presentation, what is she at an elevated risk for?
A 29-year-old woman presents to the clinic with a complaint of intense itching that has developed over the past few weeks. She is currently 32 weeks pregnant and has had an uncomplicated pregnancy thus far. The patient reports that the itch is particularly bothersome on her palms and soles. She denies any recent illness or fever and states that she otherwise feels well. On examination, there is no evidence of a rash. Blood tests reveal elevated levels of bilirubin, ALT, AST, and ALP. What should be discussed with the patient?
A woman in her 12th week of pregnancy arrives at the emergency department with a two-week history of intense vomiting and lack of appetite. The scent of food triggers her nausea. She hasn’t consumed any food for the past four days and has only had minimal amounts of water.
She is currently taking omeprazole and folic acid and has never smoked or consumed alcohol. What is an instance of a risk factor for this ailment?
A 32-year-old female who is 20 weeks pregnant has a raised serum alpha-fetoprotein (AFP) and is worried about the possible causes. What could be responsible for the elevated AFP levels in this patient?