PBL Sessions: Reproductive Organ System

Page 4

History of Present Illness:

She returns at 17 weeks gestation for a screening ultrasound. The ultrasound examination shows a fetus consistent in size for 16 weeks. No apparent anomalies are noted. The amniotic fluid index is normal.

A Hgb A1C is 5.1%. Her HbsAg test is negative. An HIV test is negative.

You schedule the next visit in 3 weeks. During the interim, she develops vaginal spotting for a day and then visits a local emergency room when there is abdominal cramping. Physical examination in the emergency room reveals no fetal heart tones. A pitocin induction is undertaken and the stillborn fetus is delivered a day later.

A fetal autopsy is performed.

Tasks

• What do these findings indicate?

• What hypotheses explain these findings?

• Explain your reasoning for the hypotheses you choose.

• What learning issues are being identified?

• What do you think the autopsy showed?

Stop !! Complete discussions and tasks before moving to the next page.