A 27-year-old woman (G1P1) gives birth vaginally at 38 weeks gestation and experiences a physiological third stage of labor. She notices some brown mucousy vaginal discharge with blood, which amounts to around 120ml of blood. Upon examination, her abdomen is soft but tender, and she has a GCS of 15, blood pressure of 130/80 mmHg, pulse rate of 88 bpm, and temperature of 36.6C. What is the most appropriate course of action for her management?
A 25-year-old patient who is 20 weeks pregnant visits your GP clinic with worries about a high reading on a blood pressure machine at home. She has no medical history and is not experiencing any symptoms. During the clinic visit, her blood pressure is measured at 160/110 mmHg and there is no indication of proteinuria on urine dipstick testing. What is the best course of action for management?
A 33-year-old woman visits her GP seeking advice after her daughter was diagnosed with chickenpox 10 days ago. The daughter developed a widespread vesicular rash. The woman is feeling fine, but she is 16 weeks pregnant and cannot recall ever having had chickenpox. An immunoglobulin test confirms this. What is the best course of action for management?
A 28-year-old woman who is 20 weeks pregnant comes for a check-up. She had contact with a child who has chickenpox earlier in the day, but she is uncertain if she had the illness as a child. What is the best course of action?
A 28-year-old Indian woman contacts her doctor for guidance. She is currently 12 weeks pregnant and had been taking care of her nephew who has chickenpox. The patient spent a considerable amount of time with her nephew and had close physical contact like hugging. The patient is feeling fine and has no noticeable symptoms. She is unsure if she has had chickenpox before.
What would be the best course of action in this scenario?
A 26-year-old woman who is 25 weeks pregnant with her second child is scheduled for a blood glucose check at the antenatal clinic due to her history of gestational diabetes during her first pregnancy. After undergoing the oral glucose tolerance test, her fasting glucose level is found to be 7.2mmol/L and her 2hr glucose level is 8 mmol/L. What is the best course of action for management?
A 35-year-old pregnant woman of South Asian descent is in her second pregnancy and is currently 10+0 weeks along. She has previously given birth naturally to a healthy child at 39 weeks and has no other prior pregnancies. Due to her family’s history of type 2 diabetes mellitus, she undergoes a fasting glucose test during her booking visit, which reveals a level of 7.2 mmol/L. What is the best initial course of action for managing her fasting glucose level?
A 28-year-old woman has been diagnosed with gestational diabetes mellitus and is referred to the joint antenatal and diabetic clinic. She is currently 25 weeks pregnant and this is her first pregnancy. Her family has no history of pregnancy-related problems, but her father has type 1 diabetes mellitus. On examination, her BMI is 32 kg/m² and otherwise normal. What diagnostic test would confirm her condition?
A 28-year-old woman presents to the antenatal clinic at 12 weeks gestation for Down’s syndrome screening. She undergoes a screening test and the results show an increased b-hCG, decreased PAPP-A, and thickened nuchal translucency on ultrasound. The chance of Down’s syndrome is calculated to be 1/80. The patient expresses her concern about the safety of the testing options for her and her baby. She has no significant medical history. What is the most appropriate next step in managing this patient?
A 35-year-old woman who is 30 weeks pregnant presents with malaise, headaches and vomiting. She is admitted to the obstetrics ward after a routine blood pressure measurement was 190/95 mmHg. Examination reveals right upper quadrant abdominal pain and brisk tendon reflexes. The following blood tests are shown:
Hb 85 g/l
WBC 6 * 109/l
Platelets 89 * 109/l
Bilirubin 2.8 µmol/l
ALP 215 u/l
ALT 260 u/l
γGT 72 u/l
LDH 846 u/I
A peripheral blood film is also taken which shows polychromasia and schistocytes. What is the most likely diagnosis?