A 32-year-old woman of Chinese Han ethnicity contacts her GP to discuss her planned pregnancy, estimated to be at 6 weeks gestation. She has a BMI of 31 kg/m² and smokes 10 cigarettes per day. Her mild asthma is well-controlled with inhaled beclomethasone. The GP recommends taking folic acid 5mg daily for the first 12 weeks of pregnancy.
What would warrant prescribing high-dose folic acid for this patient?
Sarah is a 26-year-old woman who is 28 weeks pregnant with her first child. She has not felt the baby move for 2 hours. Her pregnancy has been normal, but her baby is slightly underweight for its gestational age. She visits the obstetric emergency walk-in unit at her nearby hospital.
What is the most appropriate course of action for managing this patient?
A 19-year-old primiparous woman is being monitored on the labour ward after a midwife raised concerns about her CTG tracing. She is currently in active second stage labour for 2 hours and is using gas and air for pain relief. At 39 weeks gestation, her CTG shows a foetal heart rate of 90 bpm (110 – 160), variability of 15 bpm (5 – 25), and no decelerations. She is experiencing 6-7 contractions per 10 minutes (3 – 4) for the past 7 minutes. What is the most appropriate immediate next step?
A multiparous woman at 38 weeks gestation is admitted to the labour ward after an artificial rupture of membranes. During four-hourly vaginal examinations, the midwife suddenly palpates the umbilical cord vaginally. The woman is placed on cardiotocography, which reveals late decelerations. What should be the midwife’s next immediate step in managing the situation?
A 35-year-old woman is seen in the epilepsy clinic. She has been effectively managing her epilepsy with carbamazepine 400 mg twice daily. She is expecting a baby girl soon and is eager to breastfeed. What guidance should be provided to the patient?
A 32-year-old para 1 woman has just given birth to a large baby boy (4.2kg). The delivery was vaginal but complicated by shoulder dystocia, which was resolved with McRoberts’ manoeuvre and suprapubic pressure. Although the baby is healthy, the mother is experiencing significant pain and bleeding due to a tear. Upon examination, the midwife discovers a midline tear that extends to a small portion of the external anal sphincter. However, the internal sphincter remains intact. The patient’s vital signs are normal, and she is otherwise in good health. What is the most appropriate course of action for this patient?
A 30-year-old woman 25 weeks into her first pregnancy comes in with vaginal bleeding. What distinguishing characteristic would suggest a diagnosis of placenta praevia instead of placenta abruption?
A 29-year-old woman, who is 12 weeks pregnant, visits her midwife for a check-up. She has a BMI of 33 kg/m² and no other medical conditions. The patient is anxious about gestational diabetes, which she believes is common in larger women. She has one child previously, a boy, who was born after a complicated and prolonged delivery. He weighed 4.6kg at birth and required no additional post-natal care. There is no family history of any pregnancy-related issues. What is the most appropriate test to address her concerns and medical history?
A 35-year-old woman who has never given birth is in labour at 37 weeks gestation. During examination, the cervix is found to be dilated at 7 cm, the head is in direct Occipito-Anterior position, the foetal station is at -1, and the head is palpable at 2/5 ths per abdomen. The cardiotocogram reveals late decelerations and a foetal heart rate of 100 beats/min, which persist for 15 minutes. What is the appropriate course of action in this scenario?
A woman gives birth via normal vaginal delivery. The midwife notices the baby has an umbilical hernia, a large, protruding tongue, flattened face, and low muscle tone. What is the most probable outcome of this woman’s combined screening test at 13-weeks-pregnant with this child?