You encounter a 36-year-old woman during her antenatal check-up. She has recently undergone an anomaly scan and is undergoing a routine review. During the consultation, she expresses her concern about not feeling any fetal movement yet, despite experiencing it by 18 weeks gestation in her previous pregnancies.
At what point in her gestation would it be appropriate to refer her to the maternal fetal medicine unit for further evaluation?
A 27-year-old woman visits her GP worried about not feeling any fetal movements yet. She is currently 22 weeks pregnant and this is her first pregnancy. She is anxious because her peers who have been pregnant had already experienced their baby’s movements by this stage. When should a referral to an obstetrician be made for absence of fetal movements?
A 32-year-old pregnant woman with pre-eclampsia experienced an eclamptic seizure at 11 am today. Magnesium was administered, and the baby was delivered an hour later at midday. However, she had another eclamptic seizure at 2 pm. Both the mother and baby have been stable since then. What is the appropriate time to discontinue the magnesium infusion?
A patient 16/40 gestation contacts your clinic via phone. This is her first pregnancy and she is worried about not experiencing any foetal movements yet. You provide reassurance that foetal movements can be felt between 16-20 weeks gestation in first pregnancies. When should further investigation be considered if no foetal movements are felt by this time?
A 35-year-old woman who is 32 weeks pregnant presents with a two-week history of pruritus on her hands and feet without any visible rash. The symptoms are more severe at night and she has elevated liver function tests, with a bile acid level of 106 mmol/l. The obstetrician discusses with the patient about the possibility of induction of labour (IOL) after which week of gestation?
A 32-year-old female (P0 G1) is 28 weeks pregnant and has just been informed that her baby is in the breech position. She is considering the external cephalic version (ECV) and wants to know when she can be offered this procedure?
You are asked to assess a middle-aged woman in the maternity ward who is 5 days post-partum and reporting persistent vaginal bleeding with clots. You reassure her that lochia is a normal part of the post-partum period, but advise her that further investigation with ultrasound may be necessary if the bleeding continues beyond what time frame?
You are seeing a G3P1 14-weeks pregnant woman in the GP surgery. She is concerned about the possibility of developing postpartum psychosis again, as she had experienced it in her previous pregnancy and was hospitalized. What is the likelihood of her developing this condition once more?
A 9-year-old girl presents with her daughter, who is two weeks old and was diagnosed a few days following birth with an anterior tongue tie. She is still struggling to establish enough feeding due to poor latch and a poor seal, even though she is alternating between breastfeeding and bottle feeding of expressed milk. She has been reviewed by the health visitor twice who is satisfied with her breastfeeding technique. The baby was over the 50th centile at birth and now has dropped to the 25th centile.
Given the above, what is the next most appropriate step in the management of this child?
A 28-year-old woman presents one week following delivery with some concerns about breastfeeding. She is exclusively breastfeeding at present, but the baby has lost weight (400 g) and she finds breastfeeding difficult and painful. The baby weighed 3200 grams at the time of birth. There is pain in both nipples, worse at the beginning of the feed, and clicking noises are heard when the baby is feeding. She sometimes has to stop feeding because of the discomfort.
On examination, the breasts are engorged and there is no area of erythema or tenderness. The nipples appear normal, and there is no discharge or erythema.
Which of the following is the most appropriate next step in this patient’s management?