A 31-year-old woman is on day four postpartum, following an emergency Caesarean section for severe pre-eclampsia. She feels well in herself and is mobilising and breastfeeding well. Her blood pressure has not normalised yet and is 158/106 mmHg today. Urinalysis is negative for protein. Following a long discussion, you decide that she is ready for discharge and can be managed in the community.
Which of the following is correct regarding postnatal hypertension?
A 28-year-old primigravida presents for her booking visit at eight weeks’ gestation. She is curious to know her due date and the gender of the baby. She asks if she can have a scan as soon as possible. You inform her about the national screening programme in pregnancy and explain that antenatal scans are offered at specific stages throughout the pregnancy.
What is the most accurate description of antenatal screening using ultrasound scans?
A 27-year-old woman presents to the Emergency Department with vaginal bleeding and acute abdominal pain. She appears to be in distress and a pregnancy test comes back positive. During a vaginal examination, there are indications of tissue being expelled from the uterus. The patient is diagnosed with a miscarriage.
What type of miscarriage is she experiencing?
A 30-year-old healthy pregnant woman is about to give birth to her first child at 9-months gestation. The obstetrician decides to perform a caesarean section.
Which of the following abdominal surgical incisions will the obstetrician most likely use to perform the procedure?
A 30-year-old healthy pregnant woman is scheduled for a Caesarean section to deliver her first child at 9 months’ gestation. What type of abdominal surgical incision is the obstetrician likely to use for the procedure?
A 28-year-old woman is admitted to the Acute Gynaecology Ward with per vaginum bleeding. She is 14 weeks pregnant and has had a scan confirming an intrauterine pregnancy. She reports lower abdominal cramping and bleeding for the last two days, which prompted admission to await an ultrasound scan. You are an FY1 doctor and are called to see her as she has increasing pain and is crying in distress. On examination, she is sweaty and uncomfortable. Abdomen is soft in the upper region, but firm and very tender suprapubically. Observations show temperature 38.7 °C, heart rate 130 bpm, blood pressure 95/65, respiratory rate 22 and oxygen saturations 97% on air. Checking her pad shows fresh bleeding and speculum examination is difficult due to pain, but there is a smelly discharge and you think you see tissue sitting in the os. You manage to get IV access and starts fluid resuscitation.
What is the most important next step in management?
A 29-year-old woman presents with a positive pregnancy test and brown vaginal discharge. Four weeks ago, she was diagnosed with an incomplete miscarriage at eight weeks’ gestation, which was medically managed with misoprostol. She reports passing big clots the day after and lightly bleeding since. An ultrasound scan reports a ‘heterogeneous appearance of the endometrial cavity suspicious of retained products of conception’. Her heart rate is 100 bpm, blood pressure 100/80 mmHg and temperature 38.0 °C. Abdominal examination reveals a tender abdomen, with cervical excitation on vaginal examination.
What is the most appropriate next step in managing this patient?
A 35-year-old woman presents at 12 weeks’ gestation to see the clinician. Her risk of developing Down syndrome was calculated as 1 in 8, and she was offered a diagnostic test. Amniocentesis confirms Down syndrome. Following long discussions with her and her partner, she decides on termination of the pregnancy.
Which of the following is the most appropriate management option for this patient?
A 28-year-old woman presents at 16 weeks’ gestation, requesting an abortion. Her relationship has ended; she has moved back in with her parents, and her anxiety has worsened. She feels overwhelmed and states that, at this point, she cannot handle a baby. She has undergone a comprehensive consultation, and her decision remains the same.
What is the most suitable course of action for managing this patient?
A 27-year-old woman presents at 18 weeks’ gestation, seeking advice. She was collecting her son from school the other day when the teacher alerted the parents that a few children had developed ‘slapped cheek syndrome’. One of those children was at her house with his parents for dinner over the weekend.
She is concerned she may have been infected and is worried about her baby. She had all her paediatric vaccinations, as per the National Health Service (NHS) schedule.
Which of the following should be the next step in the investigation of this patient?