By Eugene Toy, Edward Yeomans, Linda Fonseca, Joseph Ernest
Actual sufferers, actual circumstances educate you high-risk obstetrics "This is a superb guide on excessive danger obstetrics. the suitable viewers is scientific scholars or citizens within the box who like genuine lifestyles eventualities to intensify their studying. it's best fitted to these in a time crunch, and citizens and scholars definitely qualify. three Stars."--Doody's evaluate provider Case documents: High-Risk Obstetrics makes use of fifty medical circumstances to demonstrate evidence-based perform in high-risk obstetrics sufferers. each one case contains open-ended questions, prolonged dialogue, perform Pearls, a “Controversy” dialogue, comprehension questions, and references to the most up-tp-date literature with a quick critique of every article. This distinct studying process teaches you to be a greater clinician by way of studying within the context of actual sufferers and reinforcing the most recent evidence-based medication. positive factors transparent and easy-to-follow case-based layout is helping citizens and fellows advance scientific considering abilities in response to present magazine articles and landmark reviews, with an accompanying short critique "Practical Pearls" supply evidence-based innovations for sufferer administration "Controversy" function discusses present controversies and diversified perspectives concerning every one case Multiple-choice comprehension questions accompany every one case unique line drawings and scientific photographs confirmed studying approach improves examination rankings
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Extra info for Case Files High-Risk Obstetrics
Abdominal examination reveals a 28 cm fundal height with normal bowel sounds, and she has trace pretibial pitting edema. 0 g/dL and a platelet count of 125,000/mm3. Urinalysis reveals no nitrites or leukocyte esterase, 2+ glucose, and no albuminuria. 0). Fasting glucose level was 65 mg%. ➤ Does this patient have any metabolic or physiologic changes not associated with a normal pregnancy? ➤ What is your next step in her evaluation? 14 CASE FILES: High-Risk Obstetrics ANSWERS TO CASE 1: Physiologic Adaptation to Pregnancy Summary: This is a 22-year-old primigravida who is 28 weeks’ pregnant.
ANALYSIS Objectives 1. Become familiar with first-trimester screening and diagnostic testing options for aneuploidy. 2. Understand the biochemical and ultrasound components for aneuploidy screening in the first trimester. 3. Understand combination first- and second-trimester screening modalities and their detection rates. Considerations This patient should first decide about any further testing from two broad options: noninvasive screening or diagnostic invasive testing. ” There is a longrecognized increase in the risk for fetal aneuploidy with advancing maternal age, and the increased risk takes a dramatic turn upward after the mid-thirties.
Amniocentesis would be indicated in subsequent pregnancies in the early second trimester, when visualization of a small spinal defect may not be readily accomplished. Testing for amniotic fluid acetylcholinesterase in subsequent pregnancies is routinely performed as well as AFP measurement. What obstetrical implications are associated with an unexplained MSAFP? Numerous retrospective series have delineated a relationship between unexplained elevated MSAFP and a variety of adverse outcomes. 5 MoM).
Case Files High-Risk Obstetrics by Eugene Toy, Edward Yeomans, Linda Fonseca, Joseph Ernest