A 32-year-old woman who is P1 G2 is 30 minutes post-partum of an uncomplicated delivery. Suddenly, she starts gasping for breath and appears cyanosed with a blood pressure of 83/65 mmHg, heart rate of 120 bpm, and a respiratory rate of 33/min. She becomes unresponsive. What is the probable diagnosis?
A 24-year-old woman, gravidity 2 and parity 1, at 37 weeks gestation presents with severe abdominal pain after fainting. Her blood pressure is 92/58 mmHg and heart rate is 132/min. Upon examination, she appears cold and her fundal height measures 37 cm. The cervical os is closed and there is no vaginal bleeding. What is the most suitable diagnosis?
A 32-year-old female presents with intense pruritus during pregnancy, particularly in her hands and feet, which worsens at night. She has no visible rash and has a history of a stillbirth at 36 weeks. What is the most efficient management for her condition?
A 28-year-old patient presents to the Emergency Department with fresh red vaginal bleeding and lower abdominal pain.
The patient is at 36 weeks gestation and gravida 3, para 2. She is rhesus positive and a current smoker. Access to her current maternity notes is unavailable. She tells you she has pre-eclampsia for which she takes labetalol.
Maternal observations are normal and there are no concerns with foetal movements. A cardiotocograph (CTG) demonstrates that the foetal heart rate is 140 beats/min, variability is 15 beats/min, accelerations are present and there are no decelerations noted.
On examination, the uterus is hard and tender to palpation. The doctor suspects that the foetus may be in a transverse lie. The patient’s pad is partially soaked but there is no active bleeding noted on a quick inspection.
What would the most appropriate first course of action be in this scenario?
A 35-year-old first-time mother is brought to the GP by her partner, who is worried about her current mood. He reports that she has been sleeping and eating very little since the birth of their baby, which was a month ago. What would be the most appropriate course of action to take next?
A 23-year-old pregnant woman from Sudan visits her GP with concerns about her upcoming vaginal delivery. She is currently 30 weeks pregnant and has undergone type 3 female genital mutilation. She expresses her preference to have her vagina reinfibulated after delivery, as this is what she is accustomed to. What is the recommended course of action?
Lila, a 30-year-old pregnant woman, (gravidity 1, parity 0) currently 27+5, visits her general practitioner (GP) complaining of reflux. The GP prescribes a new medication for her reflux. Upon reviewing Lila’s medical records, the GP notes that she is scheduled for a cervical smear test in two weeks. Lila reports no new discharge, bleeding, or pain. What is the recommended timing for Lila’s next cervical smear test?
A 24-year-old woman presents to the labour suite after being admitted 45 minutes ago. She is unsure of her gestational age but believes she is around 8 months pregnant based on her positive pregnancy test. She has not received any antenatal care and is currently homeless due to a violent relationship. The patient has been experiencing contractions for the past 3 hours and her waters broke 5 hours ago. Upon examination, her cervix is soft, anterior, 90% effaced, and dilated to 7 cm. The foetus is in a breech position with the presenting part at station 0 and engaged. What is the most appropriate course of action?
A 27-year-old woman who is at 38 weeks gestation is experiencing prolonged labour. She has developed gestational diabetes during her pregnancy, but it is well-controlled with insulin. During an attempt to expedite labour, an artificial rupture of membranes was performed. However, shortly after this, the cardiotocograph showed foetal bradycardia and variable decelerations. Upon examination, the umbilical cord was found to be palpable vaginally. Assistance has been requested.
What is the most appropriate course of action for managing this situation?
A 27-year-old woman who is 39+0 weeks pregnant undergoes an artificial rupture of membranes to speed up slow labour. However, soon after the procedure, the CTG shows foetal bradycardia and the umbilical cord is palpable at the vaginal opening. What is the first step in managing this patient?