A 26-year-old woman with type 1 diabetes mellitus visits her General Practitioner (GP) with her partner to seek advice on nutritional supplementation as they plan to start trying for a baby. She is not using any contraception and her diabetes is well managed, with her latest HbA1c level at 32 mmol/mol (recommended by the Royal College of Obstetricians and Gynaecologists < 48 mmol/mol). What is the most suitable recommendation for folic acid supplementation?
A 29-year-old woman comes in for her 20-week anomaly scan. This is also her first pregnancy, but she found out she was pregnant at 12 weeks’ gestation. The sonographer alerts the consultant in the room, as she has detected spina bifida. The patient mentions that her cousin had a baby with the same condition a few years ago.
Based on the information provided, what folic acid dosage would be advised for this patient in subsequent pregnancies?
A 35-year-old woman in her second pregnancy has been diagnosed with pre-eclampsia and is taking labetalol twice daily. She presents to the Antenatal Assessment Unit with abdominal pain that began earlier this morning, followed by a brown discharge. The pain is constant and radiates to the back. During the examination, the uterus is hard and tender, and there is a small amount of dark red blood on the pad she presents to you. Which investigation is more likely to diagnose the cause of this patient’s antepartum bleeding?
A 27-year-old woman, who is 30 weeks pregnant, reports feeling breathless during a routine prenatal appointment. Upon examination, you observe that everything appears normal except for mild hyperventilation. What is the probable discovery during pregnancy?
A 28-year-old woman with type 1 diabetes mellitus, well controlled on insulin, attends the Fetal Medicine Clinic for a growth scan at 36 weeks. The scan has been unremarkable, and the consultant will discuss the mode and timing of delivery today. The baby is cephalic, and the placenta is posterior and high.
Which of the following statements regarding the mode and timing of delivery in patients with diabetes is correct?
A 28-year-old woman with essential hypertension, who is taking once-daily ramipril, attends her eight-week antenatal appointment. She has a history of well-controlled asthma and depression, but is not currently on any antidepressants. There are no other significant medical issues. Her blood pressure reading in the clinic today is 145/89 mmHg. What is the appropriate management of her hypertension during pregnancy?
A woman experiences a significant post-partum haemorrhage leading to shock. Subsequently, she develops a visual field defect and severe headache. What are the most probable complications that may arise?
A 35-year-old pregnant woman attends the Obstetric clinic for a routine early pregnancy scan. She has been struggling so far during the pregnancy, suffering from extreme, persistent nausea and vomiting. On the ultrasound scan, the image observed resembles ‘a snow storm’. The physician is concerned that this may be a complete molar pregnancy.
What percentage of complete molar pregnancies go on to become invasive?
A 26-year-old woman known to be 10 weeks pregnant is admitted to the Surgical Assessment Unit with acute lower abdominal pain and vaginal bleeding. Examination reveals a large uterus and a dilated internal os. An inevitable miscarriage is diagnosed and the patient is taken to theatre for surgical evacuation. This is the patient’s third miscarriage in 3 years.
What is the percentage chance that she will have a successful pregnancy on her fourth attempt?
A 35-year-old woman diagnosed with gestational diabetes that was treated with a combination of metformin and insulin is on day three postpartum. Her medication has been discontinued, and she is ready to be discharged. You are asked to see her to discuss follow-up post-discharge.
Which of the following best describes the follow-up of women with gestational diabetes?