Clinical Case Study Essay

Premature babies sometimes have apnea. It may happen together with a slow heart rate. Respiratory distress syndrome or RDS is a breathing problem most common in babies born before 34 weeks of pregnancy.” Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. “Intraventricular hemorrhage or IVH is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid. Patent ductus ateriosus or PDA is a heart problem that happens in the connection between two major blood vessels near the heart. If the ductus do not close properly after birth, a baby can have breathing problems or heart failure. Heart failure is when enough blood can’t get pumped into the heart causing it to shut down. Necrotizing enter colitis (NEC) is a problem with a baby’s intestines. It causes feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature bay has been born. Retinopathy of prematurity (ROP) is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss. Jaundice is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well. Anemia is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body. Bronchopulmonary dysplasia (BPD) is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and

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.

Serrita is a 26yo, G3 P1011, who was seen for an ultrasound evaluation and fetal anatomy assessment. As you know, she has chronic HTN and is on methyldopa 500 mg b.i.d. Her BP is normal on today’s assessment at 130/78. Her urine evaluation was negative. She is also hypothyroid status-post a diagnosis of Hashimoto’s thyroiditis. She is on replacement therapy. She did undergo noninvasive prenatal testing (NIPT) that returned low-risk, female and her maternal serum AFP was normal at 0.58 MoM. Based on her height and weight at the start of the pregnancy, her BMI was about 38. Lastly, she is on metformin 500 mg b.i.d. She states that she believes that she was on this due to abnormal insulin levels but she was not completely certain as to why

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

Ada is a 23yo, primigravida, who is currently 37 weeks 3 days. She is being followed in our office for weekly testing due to chronic HTN. Her last growth on November 30, 2017, was appropriate for gestational age. She is here today for antenatal testing and ongoing growth due of the possibility of delivery soon. She also has had polyhydramnios that at one point was up to 31 cm but at her visit last week it was stable at 26 cm. She had been evaluated for cholestasis but reports today that bile acids have returned negative.

During our initial assessment of Ms. K.R., the following vital signs were noted: blood pressure was 147/67, temp 36.6 degrees Celsius, pulse 80 beats per min., respiratory rate of 20, pulse ox 99% on room air, a pain score of 8 during contractions, and fetal heart tones had a baseline of 130 over the last two hours. Her labs showed 2+ protein in her urine but she denied any headaches, vision changes, right upper quadrant pain, and no DTRs or colonus were observed. Ms.K.R. seemed to be handling her labor well, with the exception of being in a lot of pain and unable to find a comfortable position.

Angela is a 36yo, G5 P3013, who was seen for an ultrasound evaluation and consultation for AMA. The patient is currently 36 but would be 37 at the time of her EDD. She does have a history of chronic HTN and reportedly is on labetalol 100 mg b.i.d. but in talking to her she has actually not filled the prescription yet and therefore has not started the medication. Her BP was 141/98 on her initial check and on repeat 140/92. Her urine evaluation is negative for protein. She does have asthma but is currently asymptomatic. Based on her height and weight at the start of the pregnancy, her BMI was 44. She also does smoke cigarettes at ½ pack per day. She was counseled on cessation.

A low partial pressure of oxygen (PaO2) suggests that a person is not getting enough oxygen; Metabolic acidosis->Kidney failure, shock, diabetic ketoacidosis

Rachel is a 32yo, G7 P3033, who is currently 18 weeks 1 day. She is dated by LMP. She was seen previously for a dating scan and declined aneuploidy screening. She has 3 prior full-term deliveries. She had preterm labor with her last pregnancy but ultimately delivered at term. While she has miscarriages, she does not have 3 in a row. She is here today for an anatomic survey.

By dates, she is 24 5/7 weeks and the measurements are concordant. The amniotic fluid volume is normal. A repeat fetal anatomy was performed and further views of the face and diaphragm were seen. Again, due to fetal position and maternal body habitus the fetal heart was not cleared.

Antonia is a 42yo, G6 P5005, who was seen for a follow-up ultrasound assessment and fetal anatomy evaluation. She does have AMA and underwent full genetic counseling and elected to have noninvasive prenatal testing (NIPT). This was done and returned low-risk female. She does have 5 previous term vaginal deliveries and therefore she is grand multiparous. Lastly, she has had GDM that has required medication in her last 2 pregnancies. She states that she was told to evaluate her sugars but has not been doing so on a routine basis. With this history, we would recommend early Glucola testing. Currently at this time the patient overall has no complaints and has positive fetal movement.

A.G.’s mother states that she was born at Sunrise Hospital in Las Vegas. She was birthed through cesarean at 36 weeks. Her heart rate continued to drop so they were forced todeliver earlier than planned. There were no complications during or after birth. She weighed 7.6 pounds. A.G.’s mother denies any surgeries, hospitalizations, or mental health problems. She was diagnosed with Chicken pox at the age of 9 years old but no other major childhood illness. The Apgar score is unknown. Last eye exam was 06/2016. She wears glasses but not consistently as recommended by the Optometrists. Last dental exam was 01/2016. There were no cavities or gum disease noted. Teeth were in good condition with all 4 wisdom teeth present. Last hearing test is unknown

overexposed to oxygen for extended periods (Jobe & Kallapur, 2010). When a baby is born

Madaisa is20yo, G2 P0100, who is currently 34 weeks 4 days. She is followed in the High-Risk Upstairs Clinic secondary to a history of an abruption of an IUFD around 32 weeks. She actually presented to the hospital with fetal heart tones and had an emergency cesarean delivery but the baby was not alive. She is now being followed in weekly testing. Her growth scan 2 weeks ago was appropriate. She is here today for antenatal testing.