Chelsea is a 25yo, G3 P0111, who is currently 31 weeks 4 days as dated by LMP consistent with a 14-week ultrasound. She is obese with a BMI of 30. She has a history of chronic HTN and is on labetalol 200 mg b.i.d. In her last pregnancy, she developed preeclampsia in the trimester. She was admitted to the hospital and followed very closely. She delivered at 32 weeks for severe symptoms and oligohydramnios. She delivered via cesarean delivery due to an unfavorable cervix. She is currently on baby aspirin. She had a scan last week in your office and was noted to have an AFI of 6 cm. Because of her history, she was referred for further evaluation. She has some hand edema but her lower extremity edema is appropriate for pregnancy. She has a history of migraines and has occasional headaches but
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The amniotic fluid volume is low-normal at 8 cm. We discussed this moving forward. Because of the normal growth and Doppler’s, I am reassured and perhaps this is simply low-normal AFI. However, I would recommend that you continue with at least weekly testing. I expect that the AFI will stay around the low-normal range. If, however, it drops to < 5 cm, we could use a 2 cm deepest vertical pocket for continued management while less than 37 weeks, but I would continue steroids and refer her to our office if this occurs. As long as her AFI remains above 5 cm I would continue to follow her weekly through your office. At this time, we have not scheduled her back here. She is very well aware of preeclampsia and she should continue with preeclampsia precautions. Her BP was normal today in our office and there was no protein on her dip. Certainly, if her BP’s elevate or she develops proteinuria, I would at least check preeclampsia labs. It was a please to see Chelsea, especially since I delivered her last baby. If you would like us to perform any of her future scans, please feel free to reschedule her with
The amniotic fluid volume is low-normal at 8 cm. We discussed this moving forward. Because of the normal growth and Doppler’s, I am reassured and perhaps this is simply low-normal AFI. However, I would recommend that you continue with at least weekly testing. I expect that the AFI will stay around the low-normal range. If, however, it drops to < 5 cm, we could use a 2 cm deepest vertical pocket for continued management while less than 37 weeks, but I would continue steroids and refer her to our office if this occurs. As long as her AFI remains above 5 cm I would continue to follow her weekly through your office. At this time, we have not scheduled her back here. She is very well aware of preeclampsia and she should continue with preeclampsia precautions. Her BP was normal today in our office and there was no protein on her dip. Certainly, if her BP’s elevate or she develops proteinuria, I would at least check preeclampsia labs. It was a please to see Chelsea, especially since I delivered her last baby. If you would like us to perform any of her future scans, please feel free to reschedule her with