A 35-year-old woman with G4P3 at 39 weeks gestation presents to the labour ward following a spontaneous rupture of membranes. She delivers a healthy baby vaginally but experiences excessive bleeding and hypotension. Despite attempts to control the bleeding, the senior doctor decides to perform a hysterectomy. Upon examination, the pathologist observes that the chorionic villi have deeply invaded the myometrium but not the perimetrium.
What is the diagnosis?
A 28-year-old G2P1 woman arrives at the emergency department in the second stage of labour with the foetal head visible at the vaginal introitus. She has a history of a previous elective lower-segment Caesarean section, but no other significant medical history. Antenatal imaging revealed chorionic villi invasion into the myometrium, but not the perimetrium. Following delivery of the foetus, the patient experiences post-partum haemorrhage. What is the most probable cause of her post-partum haemorrhage?
A 33-year-old woman who is at 36 weeks gestation comes to the maternity unit for a routine check-up. Her pregnancy has been without any complications so far, and her blood pressure, urine dipstick, and fundal height are all normal. During a previous examination, a vertical scar from her previous pregnancy is visible on her abdomen, as the child was delivered via a caesarean section. She wants to discuss her delivery options and is interested in having a home birth. What is the most suitable delivery method for this patient?
A woman who is 20 weeks pregnant is worried after her recent antenatal scan revealed increased nuchal translucency. Besides Down’s syndrome, which condition is most commonly linked to this discovery?
A 46-year-old primiparous woman, who is 37 weeks pregnant, presents to the emergency department with a sudden onset of painful vaginal bleeding. She had been feeling unwell for a few days, experiencing lightheadedness upon standing. Despite being pregnant, she has not sought antenatal care, except for her initial booking visit.
Upon examination, her heart rate is 130 beats per minute, respiratory rate is 21 breaths per minute, and blood pressure is 96/65 mmHg. Her abdomen is tense, with a firm and fixed uterus.
What is the most likely risk factor for this complication in this pregnant woman?
A 28-year-old gravid 3, para 2 at 24 weeks gestation comes to the antenatal clinic to discuss delivery options for her pregnancy. She has a history of delivering her previous pregnancies through vaginal and elective caesarean section, respectively. What is the definite reason for not allowing vaginal delivery after a previous caesarean section?
A 35-year-old woman arrives at the emergency department five days after giving birth without any complications. Her husband brings her in after noticing a sudden change in her behavior. He reports that she appears confused and agitated. During the mental state examination, she describes having racing thoughts, feeling depressed, and having suicidal thoughts. Additionally, she exhibits pressured speech. What is the probable diagnosis?
A 25-year-old woman has undergone an artificial rupture of membranes to speed up a labor that is progressing slowly. While her partner is assisting her in changing positions for comfort, she suddenly becomes breathless and collapses from the bed. She is now unresponsive and unconscious, with a blood pressure of 82/50 mmHg and a heart rate of 134 beats per minute. What is the probable diagnosis?
A 30-year-old primigravida gives birth to her male infant at 40+1 weeks via ventouse-assisted vaginal delivery. The estimated blood loss is 650ml and her uterus is well contracted. An episiotomy was performed during delivery, and a tear involving perineal skin and muscle with less than 50% damage to the external anal sphincter is found on postpartum vaginal examination. What is the best course of action for this patient?
A 32-year-old woman who is 30 weeks pregnant presents with itch.
On examination, her abdomen is non-tender with the uterus an appropriate size for her gestation. There is no visible rash, although she is mildly jaundiced. Her heart rate is 76/min, blood pressure 130/64 mmHg, respiratory rate 18/min, oxygen saturations are 99% in air, temperature 36.9°C.
A set of blood results reveal:
Hb 112g/l Na+ 140 mmol/l Bilirubin 56 µmol/l Platelets 240 109/l K+ 4.2 mmol/l ALP 360 u/l WBC 8.5 109/l Urea 4.8 mmol/l ALT 86 u/l Neuts 5.9 109/l Creatinine 76 µmol/l γGT 210 u/l Lymphs 1.6 * 109/l Albumin 35 g/l
What is the most likely cause of her symptoms?