A 30-Year-Old Woman With an Abnormal Fetal Ultrasound

Craig Johnson, DO; Zachary Redus; Michael Mader, MD; Frederick Eruo, MD, MPH


April 25, 2017

Physical Examination and Workup

The patient is well-appearing on physical examination. Her blood pressure is 90/60 mm Hg, and her heart rate is 90 beats/min. She has normal respirations at a rate of 12 breaths/min, with an oxygen saturation of 96% while breathing room air and a tympanically obtained temperature of 99°F. She weighs 165 lb and has a body mass index of 28.3 kg/m2.

Cardiovascular and respiratory examinations are unremarkable. The abdomen is gravid, with a fundal height of 24 cm. The patient has positive bowel sounds in four quadrants and no tenderness to palpation. No peripheral edema or rash is present.

The patient is blood type A-positive, with a negative antibody screen. The rapid plasma reagin test is nonreactive for syphilis, and the hepatitis B surface antigen test is negative. A diabetes screen result is normal at 23.4 weeks of gestation (however, this is typically done at 26-28 weeks of gestation). The antibody screen result is negative.

The complete blood cell count demonstrates a hemoglobin level of 14 g/dL (normal range, 12-15 g/dL) and a platelet count of 290 × 103 cells/µL (normal range, 100-450 × 103 cells/µL). Urinalysis demonstrates no evidence of hematuria or proteinuria.

Figure 1.

Figure 2.

Figure 3.

Follow-up ultrasonography is performed (Figures 1 and 2), followed by MRI (Figure 3).


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