As you start your rotation on the labor and delivery floor, one of your responsibilities is to identify patients who need intrapartum group B streptococcus (GBS) prophylaxis. Which patient does NOT require intrapartum GBS prophylaxis?
A 29-year-old woman, G2P1, presents to the labor and delivery unit at 39 weeks of gestation in active labor. She reports spontaneous rupture of membranes approximately 12 hours ago and has had mild intermittent contractions over the past 6 hours. Key History: Positive GBS screening at 36 weeks gestation. Stable maternal vitals, reassuring fetal heart rate. Cervical exam: 4 cm dilation, 80% effacement, -1 station. The obstetric team decides to initiate intrapartum GBS antibiotic prophylaxis due to her positive GBS status and prolonged rupture of membranes. What is the first-line antibiotic for intrapartum GBS prophylaxis?
As you start your rotation on the labor and delivery floor, one of your responsibilities is to identify patients who need intrapartum group B streptococcus (GBS) prophylaxis. Which of the following is an indication for intrapartum GBS prophylaxis?
A 26-year-old woman presents to her obstetrician-gynecologist with a positive home pregnancy test. She is unsure of her last menstrual period (LMP) due to irregular cycles. She has experienced abdominal pain and vaginal bleeding for the last 3 days. Which of the following is an indication for performing a pelvic ultrasound to determine gestational age?
Jane, a 28-year-old woman, presents to her obstetrician-gynecologist with a positive home pregnancy test. She is unsure of her last menstrual period (LMP) due to irregular cycles. A pelvic ultrasound is performed to estimate the gestational age. Which measurement is considered the gold standard for estimating gestational age in the first trimester?
A 28-year-old woman presents for her first prenatal visit, uncertain about her last menstrual period (LMP) due to irregular cycles. She has a positive home pregnancy test and requests a pelvic ultrasound to determine gestational age. On examination, her uterus is consistent with early pregnancy, but fetal heart sounds are not audible with a Doppler device. The patient denies abdominal pain or bleeding. In which trimester is pelvic ultrasound the most accurate for determining gestational age?
A 32-year-old woman, G2P1, at 12 weeks gestation undergoes chorionic villus sampling (CVS) due to an increased risk of chromosomal abnormalities detected during her first-trimester ultrasound and screening tests. Findings: CVS Karyotype: Mosaic trisomy 16 in the placental sample, suggesting confined placental mosaicism (CPM). Amniocentesis: Fetal karyotype is normal (46,XX). Placental Tissue Analysis: Mosaicism for trisomy 21 confirmed. Which of the following outcomes is most likely in cases of confined placental mosaicism with a normal fetal karyotype?
A 35-year-old woman at 12 weeks gestation undergoes non-invasive prenatal testing (NIPT), which reveals a high risk for trisomy 21. Due to her advanced maternal age and abnormal NIPT result, she undergoes invasive prenatal testing. Findings: Amniocentesis: Fetal karyotype is normal (46,XX). Placental Tissue Analysis: Mosaicism for trisomy 21. What is a common maternal complication associated with confined placental mosaicism (CPM)?
A 32-year-old woman, gravida 2 para 1, at 12 weeks’ gestation is referred for chorionic villus sampling (CVS) due to an increased risk of chromosomal abnormalities noted during her first-trimester ultrasound and screening tests. She has no significant medical history and had a normal pregnancy with her first child. CVS Findings: Karyotype Results: Mosaic trisomy 16 detected in the placental sample. Interpretation: Confined placental mosaicism (CPM) suspected, but fetal involvement cannot be ruled out. What is the primary follow-up test to confirm whether the placental mosaicism detected on chorionic villus sampling (CVS) involves the fetus?
