Pregnancy, Childbirth, & the Puerperium


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/G17_F1.jpg"}},{"insert":"\n\nYou enjoy your work at the obstetric clinic\u2014except for the administrative red tape. Morning rush over, you\u0027re gulping a cup of coffee while trying to fill up some paperwork at the same time. \n\n\u201cDoctor, you\u0027ve got a patient,\u201d your nurse says.\n\n\u201cSend her in,\u201d you reply, setting your coffee aside.\n\nA few moments later, 29-year-old Martha is sitting in front of you.\n"}]}


{"ops":[{"insert":"Martha is currently at 26 weeks of gestation of her first pregnancy. You first saw her two weeks ago\u2014she\u0027d moved cities, and needed a new obstetrician. Her pregnancy has been without issues. She has been in excellent health for the whole of her life, with unremarkable medical, surgical, gynecological, and obstetric histories. She is not on any medications or supplements currently.\n\nMartha is in today to review the results of her fetal morphology ultrasound scan and second-trimester screening for diabetes mellitus. The fetal ultrasound shows nothing untoward. However, the screening non-fasting 50g oral glucose challenge test (OGCT) is 146 mg\/dL (normal: \u003C140 mg\/dL). You recall that first trimester screening for diabetes mellitus was negative.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/G17_F3.jpg"}},{"insert":"\n\n\u201cHow do my results look, doctor?\u201d Martha asks.\n\nYou explain that her OGCT was positive, and that you\u0027ll need to evaluate her further. Martha anxiously asks several questions which you proceed to answer. \n"}]}