A 28-year-old woman presents to a routine antenatal clinic at 16 weeks gestation. She has a history of occasional frontal headaches but no significant past medical history. During the examination, her blood pressure is measured at 148/76 mmHg. Urinalysis shows a pH of 6.5, +1 protein, 0 nitrates, 0 leucocytes, and 0 blood. What is the most probable diagnosis?
A 40-year-old pregnant woman is confused about why she has been advised to undergo an oral glucose tolerance test. She has had four previous pregnancies, and her babies’ birth weights have ranged from 3.4-4.6kg. She has no history of diabetes, but both her parents have hypertension, and her grandfather has diabetes. She is of white British ethnicity and has a BMI of 29.6kg/m². What is the reason for recommending an oral glucose tolerance test for this patient?
A 30-year-old woman comes to the clinic 8 weeks after her last menstrual period with complaints of severe nausea, vomiting, and vaginal spotting. Upon examination, she is found to be pregnant and a transvaginal ultrasound reveals an abnormally enlarged uterus. What would be the expected test results for this patient?
A 28-year-old woman gives birth vaginally at 38 weeks gestation to a healthy baby girl weighing 4.2 kg. This is her third delivery. However, she experiences ongoing bleeding even after the placenta is removed, resulting in a loss of approximately 900 ml of blood. Upon examination, her heart rate is 98 bpm, her blood pressure is 100/60 mmHg, and her oxygen saturation is 97% on room air. The medical team immediately takes an ABCDE approach and notifies senior members to become involved. What is the most likely underlying factor that has contributed to her presentation?
A 24-year-old pregnant woman arrives at 16 weeks gestation with painless vaginal bleeding, excessive morning sickness, and shortness of breath. During a routine examination, her abdomen shows a uterus that extends up to the umbilicus. An ultrasound reveals a solid collection of echoes with several small anechoic spaces. What is the probable diagnosis?
A 30-year-old woman in the delivery room experienced a primary postpartum hemorrhage (PPH) 3 hours after delivery. Following adequate resuscitation, she was assessed and diagnosed with uterine atony as the underlying cause. Pharmacological treatment was initiated, but proved ineffective. What is the most suitable initial surgical intervention?
A 35-year-old woman presents to the gynaecology department with a recent diagnosis of cervical cancer. Upon staging, it was found that she has a small malignant tumour that is only visible under a microscope and measures 6mm in width. The depth of the tumour is 2.5mm, and there is no evidence of nodal or distant metastases, classifying her disease as stage IA1. She expresses a desire to preserve her fertility as she has not yet started a family.
What treatment option would be most appropriate for this patient?
A 32-year-old woman presents with vaginal bleeding at 34 weeks gestation (gravida 3, parity 2). The patient reports no abdominal pain but is worried about the possibility of a miscarriage. She has a history of two uncomplicated caesarean sections. What is the recommended first step in diagnosing her condition?
A 32 weeks pregnant woman, who is G2 P0, presents to the emergency department with vaginal bleeding. She had suffered from severe nausea and vomiting earlier in the pregnancy which has now resolved. She has no abdominal pain, no vaginal discharge, no headache, and no pruritus. On abdominal examination, purple striae were noted on the abdomen as well as a dark line running vertically down the middle of the abdomen. A transverse lie is noticed and there is no fetal engagement. The symphyseal-fundal height is 33cm.
What is the best gold standard investigation to perform?
A 29-year-old woman presents to the emergency department with her partner. She is currently 36 weeks pregnant and G2P1. Her pregnancy has been progressing normally without concerns raised at her antenatal appointments. However, she experienced a sudden gush of fluid earlier today, which soaked her trousers. On examination, fluid is seen pooling in the posterior vaginal fornix, and a swab of the fluid returns a positive partosure. The patient is afebrile and has no other abnormal vital signs. What is the most appropriate management for this likely diagnosis?