Brittney is a 26yo, G2 P0100, who is seen for an ultrasound assessment for viability, dating, and a consultation. The patient’s primary history is a 21 week IUFD that occurred in September 2016. She had some issues with significant nausea and vomiting and had elevated liver enzymes by report and then was hospitalized and unfortunately, lost the fetus at around 21 weeks. To her knowledge there were no anomalies and no abnormalities had been seen on ultrasound prior. Attempts at genetic testing through FISH were unsuccessful. Postdelivery of that fetus, her liver enzymes returned to normal.
Laroselinda is a 30yo, G6 P5006, who is currently 19 weeks. She follows in our Subutex Abuse Clinic as well as Cherokee Health System. She has a history of polysubstance abuse but is now on Subutex through Westbrook Clinic. She currently is on 8 mg b.i.d. and does want to wean throughout the pregnancy. She is here today for her anatomic survey.
In my previous role as a Licensed vocational nurse, I worked in the outpatient setting, Perinatology, where there are high-risk pregnant patients. The patient I helped take care of, was early in her pregnancy, approximately 29 weeks, and was a patient who had been seen in this clinical office
Angela is a 31yo, G2 P0010, who was seen for an ultrasound evaluation and consultation due to an abnormal quad screen with an elevated risk for trisomy 21 of 1:27. Her inhibin A is also elevated at 3.75 MoM. She does have a longstanding history of opiate use disorder. She was on Subutex 12 mg daily (4 mg t.i.d.). She pays out of pocket for this. She has been taking intermittent ibuprofen and was told to discontinue this based on her gestational age. She reportedly is hepatitis C positive but I am uncertain of the viral load. She also states that she has a history of endocarditis in 2013. She does smoke cigarettes at ½ pack per day. She was further counseled on cessation. On today’s assessment, she has positive fetal movement. She was seen
A review of the records reveals the member to be an adult female with a birth date of 08/26/1985. The member had a diagnosis of pregnancy with leaking of amniotic fluid and suspicion of rupture of fetal membranes (ROM). The member’s treating provider, Deepti Pruthi, MD ordered a ROM Plus testing, which was performed on 03/04/2015.
The communication between providers are lacking when it comes to this patient as the patient as in the hospital for over 50 days with every specialty consulting on her case. There is no indication that the providers formed, or carried out, a treatment plan. This
Karapetian, (Director). (24, April 23). Fetal circulation [Video file]. Retrieved October 30, 2016, from https://www.bing.com/videos/search?q=fetal+circulation&qpvt=fetal+circulation&view=detail&mid=5CAF5DB3E57BE9BD89375CAF5DB3E57BE9BD8937&rvsmid=5CAF5DB3E57BE9BD89375CAF5DB3E57BE9BD8937&fsscr=0&FORM=VDMCNL