Gestation for prenatal care thinking

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Reference no: EM133848612

Ruby is 45-year-old G1P0 presents at 14 weeks 5 days gestation for prenatal care thinking she had skipped periods because of "her age." Ruby is new to your practice. She has been married for 10 years and has been sexually active for 14 years with no prior conceptions. She is Rh negative. After discussing her genetic options, she declines amniocentesis for fear of miscarriage. She chooses to have a detailed fetal survey and maternal serum quad screening. You order an OB ultrasound and quad screen.

Ruby's quad screen at 16 weeks reveals low Hcg and estriol levels. She has a fetal survey at 18 weeks revealing a fetus with choroid plexus cyst, a bright spot in the left ventricle, short humerus, club foot, and size consistent with a 15-week fetus.

Questions:

What initial medical and social history focus questions would you ask?

What labs would you order?

Had she elected an amniocentesis, what risks might apply?

What conditions are associated with advanced maternal and paternal age?

Reference no: EM133848612

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