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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Fetal Growth Restriction
Sponsored by The Indian Health Service Clinical Support Center
2. Case scenario
Evangeline Agimuk is a 36 y/o G5P3 who presents for her first prenatal visit at 32 weeks by her last period, which fell on Christmas day. She has a history of essential hypertension and is taking atenolol 25 mg daily. She smokes 10-15 cigarettes a day but denies use of any other recreational drugs. She says that all her babies have been small but doesn't recall their birth weights. Have you identified any risk factors?
Here's more...
Her weight today is 121 pounds, and this represents a total weight gain for the pregnancy of 6 pounds, as calculated from a weight obtained during an urgent care visit shortly before the pregnancy. Her BP is 153/93 and her urine dipstick is negative for protein. The fundal height measures 27 cm and a nonstress test is reactive. Have you identified any more risk factors?
And some more...
Composite ultrasound biometry gives an estimated gestational age of 29 weeks 5 days, +/- 17 days, and calculates an estimated fetal weight of 1191 g, which is at the 14th percentile for her menstrual dates. Measurements give the following gestational age estimates: BPD-30 weeks 3 days, HC-31 weeks 6 days, AC-27 weeks 4 days, FL-28 weeks 5 days. The AFI is 9.9 and the fetus appears to be structurally normal. What constitutes appropriate management and counseling of this patient?
