Question

son for Consultation: High-risk pregnancy with lete-term bleeding History of Present IIiness Patient is a 23-year-old female. She is currently estimated to be at 175 days of gestation. She has had a 23-lb weight gain with this pregnancy. Amnlocenteses at 20 weeks Indicated male fetus with no evidence of genetic or developmente disorders. She noticed a moderate degree of vaginal bleeding this morning but denles any cramping or pelvic pain. She immediately saw her obstetrician who referred her for high-risk evaluation. Past Medical History: This patient is multigravida but nullipara with three early miscarriages without obvious cause. She was diagnosed with cancer of the left ovary four years ago. It was treated with a left oophorectomy and chemotherapy. She continues to undergo full-body CT scan every six months, and there has been no evidence of metastasis since that time. Menarche was at age 13, and her menstrual history is significant for menorrhagla resulting in chronic anemia. Results of Physical Exam: Patient appears well nourished and abdominal girth appears consistent with length of gestation. She is understandably quite anxious regarding the sudden spotting. Pelvic ultrasound indicates placenta prevla with placenta almost completely overlying cervix. However, there is no evidence of abruption placentae at this time. Fetal size estimate is consistent with 25 weeks of gestation. The fetus is turned head down, and the umbilical cord is not around the neck. The fetal heart tones are strong with a rate of 130 beats/minute. There is no evidence of cervical effacement or dilation at this time. Recommendations: Fetus appears to be developing well and in no distress at this time. The placenta appears to be well attached on ultrasound, but the bleeding is cause for concern. With the extremely low position of the placenta, this patient is at very high risk for abruption placentae when cervix begins effacement and dilation. She may require early delivery by cesarean section at that time. She will definitely require C-section at onset of labor. At this time, recommend bed rest with bathroom privileges. She is to return every other day for two weeks and every day after that for evaluation of cervix and fetal condition. She is to call immediately if she notes any further bleeding or change in activity level of the acer OI

Answer 1

1.The patient for her ovarian cancer (left ) has undergone left oopherectomy (removal of ovary ) and chemotherapy before 4 years.She is also on regular check up every sic months for any metastasis

2.The patient attended menarche at the age of 13.She experienced a heavy bleeding (menorrhagia) during her menstrual cycle.This blood loss resulted in chronic anaemia

3.Placenta previa  refers to the presence of placenta near the cervix or covering it.The patient has undergone a pelvic ultrasound to discover this condition

4.Oopherectomy:

This is a Greek word stating oopherous (egg or ovary ) ectomy (removal)

In simple term it refers to remivalnof the ovary

Menarche

This is the first bleeding via birth canal or getting first menstrual cycle by a female.

Menorrhagia :

The term refers to heavy bleeding or prolonged bleeding.This may be due to various underlying causes resulting in severe blood loss

Placenta previa

This refers to the attachment of the placenta near or above the cervix.In simple words the placenta lies low in th uterus

Cervical effacement

This is the thinning of cervix .It happens usually during the labour whee the 4cm bottleneck cervix thins out and paves way for delivering the baby.