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 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?
A 35-year-old woman who is 8 weeks pregnant with twins presents to the early pregnancy unit with a 3-day history of vomiting and postural dizziness. The patient is gravida 2, parity 0, and never had such severe sickness in her previous pregnancy. No one else in the family is sick.
She has a past medical history of hypothyroidism and takes levothyroxine.
During examination, her BMI is 16 kg/m² and she has lost >5% of her body weight in the last 3 days. She is visibly dehydrated and her blood pressure is 98/75 mmHg.
What aspect of the patient’s history poses the highest risk for the development of this condition?
A 27-year-old primigravida woman presents to the maternity centre in labour at 39 weeks. She has been diagnosed with HIV and has been on regular antiretroviral therapy. Her viral load at 37 weeks is as follows:
HIV Viral Load 35 RNA copies/mL (0-50)
What delivery plan would be most suitable for this patient?
A Cardiotocogram (CTG) is conducted on a 32-year-old woman at 39 weeks gestation who has arrived at the labor ward in spontaneous labor. The CTG reveals a fetal heart rate of 150 bpm with good variability, and it is a low-risk pregnancy. The midwife contacts you with worries about the presence of late decelerations on the CTG trace. What is the most suitable course of action for management?
A 28-year-old woman presents for guidance as she has just discovered she is expecting her first child. She has a family history of diabetes (mother, aunt, grandmother). Apart from taking folic acid, she is healthy and not on any regular medications. What screening should be recommended to her?
You are observing an antenatal clinic and your next patient is a 26-year-old woman who is 16 weeks pregnant with her first child. Take a brief history of this patient.
The patient has a past medical history of coeliac disease and hypothyroidism. She takes no regular medications and has no known drug allergies. Her family history is relevant for her father has type 1 diabetes. She has never smoked and since pregnancy, has stopped drinking alcohol.
What additional tests, if any, should be arranged for this patient based on her medical history?
A 25-year-old woman who is 9 weeks pregnant presents for a review of her booking bloods. Her haemoglobin level is 105 g/L and the mean cell volume (MCV) is 70 fL, which is below the normal range of 77-95 fL. What is the best course of action in this situation?
A 32-year-old primiparous woman is 33+6 weeks pregnant. At her last antenatal appointment, she had a blood pressure reading of 152/101 mmHg. She mentions experiencing some swelling in her hands and feet but denies any other symptoms. Her urinalysis shows no protein. She has a history of asthma, which she manages with a salbutamol inhaler as needed, and depression, for which she discontinued her medication upon becoming pregnant. What is the optimal course of action?
A 30-year-old woman, para 2+ 0, has given birth to a healthy baby. The third stage of labor was actively managed with Syntocinon, cord clamping, and controlled cord traction. The midwives examined the placenta, which appeared complete. However, the woman is experiencing postpartum bleeding and has lost an estimated 1,500 ml of blood. She has no prior medical history. What is the initial pharmacological treatment of choice to stop the bleeding?