Clinical Case: Bad Obstetric History

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pregnancy week 10

Clinical Case

A 28 years old presented with 12 weeks gestation. She has previous history of one intrauterine death at 35 weeks. How will you proceed?

Solution

We will proceed by taking detailed history and carrying out investigations.

Detailed history:

Detailed history will include specific emphasis to following points:

  • Metabolic disease
    • Diabetes mellitus
  • Preecclampsia
  • Drug history
  • Antiphopholipid syndrome
  • Fetal heart present
    • Never
    • Disappeared before loss
    • Present still
  • Family history of thromboemolic phenonmenon
  • Consanguinous marriage

Investigations:

Both general and specific investigations will be carried out.

  • General:
    • Blood complete count
    • Blood group and cross match
    • TSH, Blood sugars
    • FSH, LH and prolactin
    • LFTs
    • RFTs
  • Specific:
    • Ultrasonography
    • Hormonal profile

Karyotyping

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The writer enjoys medical education and has special interest in community medicine.