Bethanie Case Study Nursing

Bethanie is a 32yo, G2 P0100, who is currently 11 weeks 3 days as dated by LMP consistent with a 6-week scan. She is known to our office from her prior pregnancy early in 2016. She was followed in our office for diabetes and had had a normal anatomic survey. About one week later she presented with cramping for a couple of days and on arrival she was noted to be 1 cm dilated and 90% effaced. The bag of os was noted to be at the external os. Because of her cramping an amniocentesis was performed which was negative for overt infection and a rescue cerclage was placed. Unfortunately, about one week later her water broke and she ultimately delivered a nonviable fetus. She did have chorio on placental pathology by the time of delivery. She does report that despite this history of possible type 2 diabetes that she has not required any medication and she had an early 1-hr glucose this pregnancy that was negative. She also has some fairly significant social issues as she is currently in the middle of separating from her husband due to domestic violence. She is here today to discuss her history in her prior pregnancy as well as possible FTS.

The nuchal translucency measured 1.5 mm. The nasal bone was suboptimal due to fetal positioning. I first counseled Bethanie on FTS. After appropriate counseling based on her age bas4ed risks she declined any further screening due to a reassuring