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Sample case for the residents/attendings out there. This is based on a real life example I dealt with recently. Consider it oral board prep.
You are covering ED/L and D call for your group/hospital. A 32 year old G10P5 comes into triage with a complaint of contractions. She says she is visiting family in the area and gets prenatal care in another state over 4 hours away. She claims to be 36 weeks pregnant. She has no prenatal records with her. It is 8pm currently.
She has normal vitals and is put on the monitor.
Category 1 fetal tracing.
She is contracting every 5-7 minutes.
Past Hx:
5 prior cesarean deliveries
Abdominoplasty
Breast augmentation
Lap chole
5 term cesarean deliveries for various reasons.
4 pregnancy losses/terminations
She denies any complicating issues this pregnancy other than having 4 prior C sections.
NKDA
BMI 28
She states the contractions are painful (5/10).
You have a 24 hour in house anesthesiologist. You have a fully functioning L and D. You can call in a partner for backup/assists.
What is your next steps in evaluating and managing this patient? Labs? Imaging? Physical exam? Any medications?
Any specific concerns with this patients prior obstetric history?
You are covering ED/L and D call for your group/hospital. A 32 year old G10P5 comes into triage with a complaint of contractions. She says she is visiting family in the area and gets prenatal care in another state over 4 hours away. She claims to be 36 weeks pregnant. She has no prenatal records with her. It is 8pm currently.
She has normal vitals and is put on the monitor.
Category 1 fetal tracing.
She is contracting every 5-7 minutes.
Past Hx:
5 prior cesarean deliveries
Abdominoplasty
Breast augmentation
Lap chole
5 term cesarean deliveries for various reasons.
4 pregnancy losses/terminations
She denies any complicating issues this pregnancy other than having 4 prior C sections.
NKDA
BMI 28
She states the contractions are painful (5/10).
You have a 24 hour in house anesthesiologist. You have a fully functioning L and D. You can call in a partner for backup/assists.
What is your next steps in evaluating and managing this patient? Labs? Imaging? Physical exam? Any medications?
Any specific concerns with this patients prior obstetric history?