Bilateral renal agenesis is a lethal abnormality.
US abnormalities: Its diagnosis is based initially on anhydramnios at 16 weeks’ gestation, nonvisualization of renal structures bilaterally, with a persistently empty urinary bladder.
Additionally, the adrenal gland will show a linear appearance but can sometimes appear ovoid in certain scans, and can be mistaken for the kidney. So, it is essential to carefully evaluate the empty renal fossa with absent renal arteries on color Doppler ultrasonography for an accurate conclusion
Views today demonstrate a viable singleton fetus at 31 weeks 0 days in vertex presentation with an anterior placenta. Fetal biometry appears symmetric and corresponds with stated EDD falling at the 56%ile. Interval growth is noted; however, the growth percentage did trend down from the 80%ile to the 56%ile. Follow-up fetal anatomy visualized as normal or was previously documented as normal. Ductal velocity today measured at 69.2 cm/se, which falls within normal limits. AFI remains reassuring at 12.6 cm. BPP 8/8. Doppler studies are normal in value and wave form.
Keia is a 31yo, G2 P0100, who is currently 9 weeks 6 days as dated by a 6-week scan that was off from her LMP. She has a history of an IUFD at 29 weeks. She reports that she had decreased fetal movement prior to coming in and there being no fetal heart tones on examination, but other than that there were no other significant precipitating events. She did have an increased risk for Down syndrome at 1:140 but per the old reports all of her analytes were within normal limits. At the time of delivery, the baby did appear to be appropriate weight and there were no obvious causes at the time of delivery. She reports that she had chromosomes performed after and the chromosomes were negative. She also thinks she had a full autopsy that was unremarkable. She did have a work-up for clotting disorders due to the history of loss and according to the chart everything is relatively within normal limits except for MTHFR which was heterozygous for C677T and A1298C. I did not see beta-2 glycoprotein or antithrombin III. Because of the relatively normal work-up she is on a baby aspirin and Metanx. She is here today to discuss her history and plans for this pregnancy.
By dates, the patient is 35 5/7 weeks and the measurements are concordant. The amniotic fluid volume is normal. The fetus is in cephalic presentation. The BPP and Doppler studies are reassuring. A complete fetal anatomical survey was performed and no major malformations were noted at this time within the resolution of the ultrasound equipment other than the fetal abdomen. There is a cystic structure seen in the fetal abdomen that is about 3 cm in diameter with some echolucency surrounding this. It is below the kidney but above the fetal bladder as identified in your office.
On today’s evaluation, she is 13 6/7 weeks and the crown-rump length measurement is concordant. The nuchal translucency measurement fell within the normal range. The nasal bone was identified, and there was normal ductus flow.
On today’s evaluation, she is 19 weeks and the fetal measurements overall are concordant. The long bone measurements are within one week of her dates. The amniotic fluid volume is normal, and the cervix is long and closed. A complete fetal anatomical survey was performed and a significant amount of ventriculomegaly/hydrocephalous was identified but no other major malformations were noted at this time, though due to the
On ultrasound there is a live fetus in breech presentation. Fetal biometry is consistent with menstrual dates. A detailed anatomic survey was unremarkable but slightly suboptimal
On today’s ultrasound, a single living IUP is identified with the fetus currently in cephalic presentation with a 3-vessel cord with normal insertion into an anterior right-sided placenta. Fetal biometry today demonstrates an EFW at the 31%ile for reported gestational age. A detailed anatomic survey is without any notable structural abnormalities; however, portions of the fetal face and heart remain to be well visualized due to the fetal position. There was some concern on outside ultrasound for possible cervical shortening and due to this a transvaginal ultrasound was performed that
On ultrasound, there is a live fetus in breech presentation. Fetal biometry is symmetric and consistent with dates. A detailed anatomic survey was overall unremarkable but we were unable to adequately obtain fetal cardiac views in order to complete the echocardiogram. Both myself and the sonographer scanned and unfortunately the fetus remained in the spine up position after an extended amount of
She had an 8-week ultrasound that confirmed her dates. She now is 11 ½ weeks and is interested in a FTS. The nuchal translucency measurement fell within the normal range. The nasal bone was identified, and there was normal ductus flow. She therefore underwent laboratory testing and the complete result of this screen should be available in the next 4-7 days. If the result of this screen returns with decreased risks, we would recommend a good fetal anatomical survey between 18-22 weeks gestation.
List the complications this newborn may have. Using assessment findings and OB history, explain why the complications may be present. LGA, hypotonic, nasal flaring, grunting, retractions, tachypnea, transient apnea, diminished breath sounds, lethargic, high-pitched cry, mottled skin and slight pallor: The newborn may be hypoglycemic d/t the mother having a hx of gestational diabetes and uncontrolled diabetes with this pregnancy IV. Newborn Labs: Mark the box corresponding to the patient’s lab level: low, WNL, or high. Give a rationale for abnormal labs.
This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks
Hypospadias is a birth defect in boys, where the opening of the urethra is not in the proper place. With hypospadias, the abnormal formation of the urethra in the penis occurs in the 8th to 14th weeks of gestation. There a differing degrees of hypospadias. It is generally considered minor when the urethra is placed just below the end of the penis. More severe forms range from the urethra opening being placed at mid-shaft to behind the scrotum.
Deutsche Bank made its entrance into the world in 1870 and it was one of the first banks to adopt universal banking as it promoted and facilitated trade relations between Germany and other overseas markets. Deutsche Bank acquired smaller banks in Germany in order to be the most prominent bank in their home base in addition to having a global reach. Following World War I, inflation took over Germany causing many borrowers to default on their loans forcing the bank to sell most of its assets in order to stay alive (however that diminished their global presence). The bank’s involvement during World War II with the transferring of the Jewish customers holdings to the German Government led to the Allied
G4 P3003 (4 Gestations, 3 Full Term, 0 Preterm, 0 Miscarriages, 3 Currently Living); 3 Spontaneous Vaginal Deliveries; Last birth was 7 years ago by SVD, weighed 4000 grams; No previous obstetrical complications or morbidity; No past medical history; No past surgical history; No prior antenatal care
A 2-months old male baby presented to our emergency unit with irritability, urine retention with previous history of catheterization 10 days earlier for a similar attack