Jennifer is a 28yo, G2 P0010, who is currently 23 weeks 0 days. She felt an impalpable mass on her neck and has had work-up. She has since been referred to ENT. Thyroid studies are normal with a TSH of 1.8 and a free T4 of .94 indicating a cold nodule per her report. An ultrasound performed recently was suspicious for a thyroglossal duct cyst. She is scheduled to have a biopsy on December 28, 2017. She was referred today to discuss the nodule.
On ultrasound there is a live fetus in breech presentation. Fetal biometry is consistent with dates. A detailed anatomic survey was overall unremarkable and there were no gross structural abnormalities seen. There was some concern for a mildly echogenic bowel, but no other common markers of aneuploidy were seen.
I had a long discussion with Jennifer and her partner today.
1. We first discussed her thyroid. If in fact this is thyroglossal duct cyst there should be no significant complications of pregnancy. The biopsy is important to rule-out anything that could be significant such as a malignancy. She will continue to follow-up with ENT per their suggestions.
2.
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In regard to her ultrasound, we discussed the finding of an echogenic bowel. I was able to get a verbal report on her quad screen that was screen negative with a risk at 1:7000. Even modifying that risk for echogenic bowel, we would still be better than her age based risk which is overall reassuring. We discussed the other etiologies of echogenic bowel including TORCH infections, cystic fibrosis, and bleeding. She has not had any obvious bleeding where we would suspect fetal swallowing, but it is still a possibility. Her CF screen is negative which reduces this risk significantly. I suggested that she have TORCH titers drawn, both IgM and IgG at her next visit for her Glucola in early
Abstract: The objectives of this lab was to identify the internal and external anatomy of the fetal pig. The experiment was conducted by dissecting a fetal pig and actively seeing the external anatomy, Oral Cavity, Digestive System, Circulatory System, Respiratory System, Urogenital System, and Nervous System.
During pregnancy an echocardiogram of the fetus can be done to produce images of the heart by sending ultrasonic sound waves to the vital organ. These sound waves create an image for the physician to analyze the babies heart function, structure sizes, and blood flow. A positive diagnosis before birth has shown to improve chances of survival, and will allow for appropriate care to be readily available at birth. If a baby is born without being diagnosed with the heart defect, some symptoms previous noted such as low oxygen levels can be suggestive of hypoplastic left heart syndrome. The baby may not display any symptoms or signs for hours after birth because of the openings allowing for blood to be pumped to the rest of the body. However, listening to the babies heart can revel a murmur indicating an irregular flow of blood in the heart. If a murmur is heard, or signs of the defect are observed, diagnostic tests will be ordered and performed. An echocardiogram is still the go-to test once the baby is born to evaluate the heart. The echocardiogram will diagnose the newborn, by revealing the underdeveloped left ventricle, mitral and aortic valve, and the ascending aorta commonly seen in
Heather Kelly is a 42-year-old female here today with pain and a lump in the left axillary area. I am also concerned for some fullness that I feel that. I talked with her about the options. I am going to have her do an ultrasound of that area and I will review results with her when available. Should her symptoms change over the weekend, she can certainly seek care if necessary, though I suspect that will be necessary. I have asked her to avoid over manipulating the area, as she may inadvertently make that worse. She was comfortable this plan. She will contact me with questions or concerns. All questions were answered in the office
Peterson-Iyer, Karen. "Confronting a Fetal Abnormality." http://www.scu.edu. Santa Clara University, Jan. 2008. Web. 13 Mar. 2014. .
Deering, S.H. (2004). Abruptio placentae. Department of obstetrics and gynecology: Madigan army medical center, 2, 3.
Obstetric Ultrasound -- a Comprehensive Guide to Ultrasound Scans in Pregnancy. Mar. 2006. Web. 13 Apr. 2011. .
Raisbeck, E. (2009) Understanding Thyroid Disease. Practice Nurse [online]. 37(1), pp. 34-36. [Accessed 16 March 2014].
Our mutual patient Darlene Boyle was seen in the clinic on 7/5/16 for medical clearance. Her EKG and Chest X-Ray was within normal limits. Her CBC showed elevated WBC's and she will be referred to Hematology. However, there are no finding that would prevent the patient from going through with her surgical procedure.
On ultrasound there is a live fetus in transverse presentation. Fetal biometry is symmetric and consistent with dates. A detailed anatomic survey was unremarkable, although the spine and 4-chamber heart were
On ultrasound, there is a live fetus in cephalic presentation. Amniotic fluid is generous but normal at 22 cm. Umbilical artery Doppler was within normal limits. BPP is 8/8.
When a mother finds out she is pregnant it is a wonderful experience. Most people are excited to see their first “picture” of their baby, the ultrasound. Even more exciting is getting an ultrasound to find out the sex of the baby. But ultrasounds are useful for more than just getting that first image of the fetus or finding out whether it is a boy or a girl. While it is something most parents dread finding out when pregnant, an ultrasound can also detect a birth defect. There are many different birth defects that can be detected by an ultrasound during pregnancy like Spina Bifida, Down syndrome, and abnormalities with the heart and lower urinary tract, and the importance of detecting them with an ultrasound is shown in the benefits of discovering the birth defect early, and the options it gives the parents after discovering the birth defect.
...side begins to grow and develop at six weeks the baby is only five eights of an inch in measurement. As the months go on the baby goes thru many changes as well as the mother and her body. The mother may tend to get ill at times or may be fine during her pregnancy. There are also reports that the father may become ill at times as well along with the mother, this is common in men.
The good news is, that it can be detected as early as 14 weeks into the pregnancy. Regular check ups and regular ultrasounds are important to make sure that the organs are developing properly. It is also important to make sure that the hole that the organs have come through does not close too tightly. At that point delivery may become necessary for the health and safty of both mommy and baby. Also, just because one baby was born with gastroschisis doesn't make others to follow more likely to develop it according to different studies.
According to her parents, she was very active and didn’t have any other health histories. These changes had happened suddenly and they brought her to the hospital for further evaluation and checkup. Parents were very anxious, very tearful, and do not know how to help their child. Physician ordered a stat head computerized tomogram (CT) and the CT revealed a huge mass on her frontal area of the brain suspected malignancy. The neuro surgeon explained them she needed a stat surgical removal of the tumor and the girl need to be in the hospital for quite long time for further treatment. The doctor could not give them much hope on whether or not the girl’s tumor would be treated and if she would go back to her normal
A 57-year-old female presents to her physician with changes in her bowel habits for the past few weeks. The patient reveals that she usually has soft bowel movements once a day. However, she has started passing pellet-like stools that alternate with loose stools. Her current symptoms are associated with sense of bloating and abdominal fullness. The patient denies seeing blood in her stool, weight loss, low-grade fever, a family history of colorectal cancer, or previous colon cancer screening. Abdominal examination reveals normal bowel sounds, no tenderness to palpation, and no evidence of a mass. Rectal examination is normal, and stool is negative for occult blood. Which of the following is the most appropriate next step in the management of