27 Jan A 36-year-old Hispanic woman presents to the OB clinic for her Week 24 check-up
A 36-year-old Hispanic woman presents to the OB clinic for her Week 24 check-up, gravida 2 para 1. Patient is a full-time homemaker. Pt states she is doing well but is worried about her weight gain. Obstetric history includes a normal spontaneous vaginal delivery (NSVD) 31/2 yrs ago with a viable 9 lb male infant after a 10-hour labor. No complications during pregnancy, delivery or postpartum period. She denies allergies to food, drugs or the environment. Current meds include Prenatal vitamins 1/day and Fe 90 mg/day. Family history significant only for diet- controlled DM in paternal grandfather and an aunt and obesity in both mother and father.
Objective Info
Height 5’2” Wt 170 lbs; BMI 31.1; 140/84 (sitting); HR-92/min
• HEENT: Normocephalic, no lumps/lesions
• Neck: supple without adenopathy , no thyromegaly.
• Lungs: Eupneic, CTA-bilaterally
• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, no
edema noted
• Breast: Soft, fibrocystic changes bilaterally noted without masses, dimpling or discharge,
no redness or inflammation noted. Breast self-exam reviewed
• GU: Uterus at umbilicus-approximately 24 wks size and non-tender. FHT present with
Doppler
Questions
1. What other information do you need?
2. What diagnostic tests would be appropriate for this pt?
3. What are the risk factors for this patient?
4. What other screenings are appropriate for this patient?
5. What management treatment would be most effective for this patient?
6. What are the possible maternal and newborn complications with this health problem?
