A 20-year-old primigravida presents to your clinic with a complaint of persistent vomiting. She is currently 12 weeks pregnant and has been experiencing this symptom for the past four days. Upon examination, you note that she has a fast heart rate, low blood pressure upon standing, and her urine test shows the presence of ketones. What is the most significant risk factor for hyperemesis gravidarum?
A 34-year-old G3P2 woman comes to the antenatal clinic seeking advice on Down syndrome screening. She is currently 12+6 weeks pregnant and has had 2 previous caesarean deliveries. Although her previous children did not have Down’s syndrome, she is worried about the effect of her advancing age on the likelihood of her baby being born with the condition. What tests would you suggest for this patient to assess her risk?
A 26-year-old woman goes for her first ultrasound and discovers that she is carrying monochorionic twins. Her GP advises her to inform them immediately if she experiences sudden abdominal distension or shortness of breath. What is the complication of monochorionic multiple pregnancy that the GP is referring to?
Which of these is a possible indication for induction of labour in a 30-year-old woman?
A 32-year-old woman who is 9 weeks pregnant visits you for her booking appointment. She has a brother with Down syndrome and wants to know more about the screening program. You provide information about the combined test. What other blood markers, in addition to nuchal translucency, are measured?
A 28-year-old woman contacts her GP via telephone. She is currently 20 weeks pregnant and has had no complications thus far. However, she is now concerned as she recently spent time with her niece who has developed a rash that her sister suspects to be chickenpox. The patient is unsure if she had chickenpox as a child, but she had no symptoms until the past 24 hours when she developed a rash. She feels fine otherwise but is worried about the health of her baby. What is the most appropriate course of action at this point?
A 30-year-old G1P0 woman in her 12th week of pregnancy presents to the emergency department with severe nausea and vomiting that has been worsening over the past week. She reports difficulty keeping any food down over the past 24 hours and noticed a small amount of fresh blood in her vomit. She denies any abdominal pain or change in bowel habits. Despite using cyclizine tablets, her symptoms have not improved. The patient has no significant medical history.
The following blood tests were taken and revealed abnormal results: Na+ 140 mmol/l (reference range 135-145 mmol/l), K+ 3.3 mmol/l (reference range 3.5-5.0 mmol/l), Cl- 100 mmol/l (reference range 95-105 mmol/l), HCO3- 23 mmol/l (reference range 22-28 mmol/l), urea 13 mmol/l (reference range 2.0-7.0 mmol/l), creatinine 80 mmol/l (reference range 55-120 umol/l), and blood glucose 6.0 mmol/l (reference range 4.0-7.8 mmol/l). A urine dipstick revealed 4+ ketonuria but no white or red cells.
What is the most appropriate course of action for this patient?
A 25-year-old woman attends her first antenatal appointment, believing she is 10 weeks pregnant. Which of the following is not typically done during this appointment?
A 35-year-old woman gives birth to twins through vaginal delivery after induction. She experiences a blood loss of 800ml and continues to bleed, but her haemodynamic status remains stable. What should be the next course of action in managing this patient?
A 29-year-old woman who is 10 weeks pregnant presents to the early pregnancy assessment unit with vaginal bleeding and abdominal pain that started yesterday. She has a history of Von Willebrand disease. A trans-vaginal ultrasound scan confirms a missed miscarriage. The patient is currently stable without fever or hemodynamic instability. What is the most suitable initial approach to manage this patient’s miscarriage?