11-29-2015, 03:43 AM
A 45-year-old white woman, gravida 2, para 1, who is at 10 weeks' gestation, comes to the office for her first prenatal visit following a successful implantation of an egg from an anonymous donor. Two weeks ago, pelvic ultrasonography obtained at a fertility clinic showed an 8-week viable pregnancy. Today, the patient expresses concern about her advanced maternal age, and she asks if she is at increased risk for maternal or fetal complications in this pregnancy. She has a 20-year-old son from a previous marriage. Her first pregnancy was uncomplicated and resulted in a spontaneous vaginal delivery at term. The patient underwent diagnostic laparoscopy 2 years ago for evaluation of pelvic pain; no abnormalities were disclosed at that time. Medical history is otherwise unremarkable and she takes no medications except for prenatal vitamins. She is 165 cm (5 ft 5 in) tall and weighs 63 kg (140 lb). Vital signs are temperature 36.1°C (97.0°F), pulse 64/min, respirations 20/min, and blood pressure 110/76 mm Hg. Uterine size is consistent with a 10-week gestation. Fetal heart rate is 148/min. Which of the following is the most appropriate screening test for this patient at this visit?
A Amniocentesis
B Blood screening for ABO and Rh type
C Determination of serum TSH concentration
D Ultrasonography of the pelvis
E Vaginal culture for group B streptococcus
A Amniocentesis
B Blood screening for ABO and Rh type
C Determination of serum TSH concentration
D Ultrasonography of the pelvis
E Vaginal culture for group B streptococcus