03-25-2007, 03:38 PM
A 17-year-old woman is in your office today for her first prenatal visit. She is 29 weeks pregnant and complaining of cramping pain. Tocodynamic monitoring reveals regular uterine contractions. A sterile vaginal examination reveals 2- to 3-cm dilatation and 80% effacement, with intact membranes. As you inform her that she is in preterm labor and has to be admitted to the hospital, she tells you she has been feeling weak lately and shows you the following laboratory test results ordered by her primary care physician:
Blood type, O positive
Antibody screen, positive for the Du antibody titer 1: 8
Hemoglobin, 9.0 mg/dL
Hematocrit, 30.9%
Platelet count, 169 x 109/L
Glucose, fasting, 79 mg/dL
Creatinine, 0.7 mg/dL
Thyroid-stimulating hormone (TSH), 0.60 µU/mL
Anticholinesterase-receptor antibody, positive
Based on these results, what would you tell her?
A. Her baby is probably isoimmunized, and she will need percutaneous umbilical blood sampling
B. She is weak secondary to anemia and will be prescribed magnesium tocolysis
C. Under no circumstance should she be prescribed magnesium tocolysis
D. She is probably hyperthyroid, and she needs further testing
Blood type, O positive
Antibody screen, positive for the Du antibody titer 1: 8
Hemoglobin, 9.0 mg/dL
Hematocrit, 30.9%
Platelet count, 169 x 109/L
Glucose, fasting, 79 mg/dL
Creatinine, 0.7 mg/dL
Thyroid-stimulating hormone (TSH), 0.60 µU/mL
Anticholinesterase-receptor antibody, positive
Based on these results, what would you tell her?
A. Her baby is probably isoimmunized, and she will need percutaneous umbilical blood sampling
B. She is weak secondary to anemia and will be prescribed magnesium tocolysis
C. Under no circumstance should she be prescribed magnesium tocolysis
D. She is probably hyperthyroid, and she needs further testing