Reference no: EM133461507
Assignment:
Maternal presentation prior to delivery
This is a 27y.o. Gravida 1 para 0 mother at 41 1/7 weeks gestation. Maternal history complicated for: 1) post dates induction, 2) Transfer of care from Queen Street Family Health for (+) HSV outbreak & concerns for possible C-Sec (recurrent), last outbreak 4 weeks prior treated with valtrex last dose 3 days ago, 3) examination 3 days ago without lesions, decision to have trial of labor with induction, 4) GBS (+), 5) Rh (-), 6) prolonged PROM x 26 hours, 7) concerns for chorioamnionitis, 8) maternal temp. 38.1ºC ( 100.6ºF), 9) fetal scalp electrode, 10) variables with fetal brady & good beat to beat variability, 11) allergy to penicillin, treated with ancef & gentamicin (gent. added for chorio. concerns), 12) IUPC (intrauterine pressure catheter), 13) cervical Foley
Maternal medications in pregnancy: Rhogam, Ancef, gentamicin, penicillin x1 dose then developed hives, clindamycin x2 doses PTD, misoprostol, pitocin, benadryl, nubain, Tylenol x1, epidural & pre-natal vitamins with folic acid & valtrex.
Pre natal labs: maternal blood type A (-), antibody (-), rubella-immune, RPR-non reactive, HepBsAg (-), GBS (+), glucola 92, platelet count 309k, GC & Chlamydia
(-), varicella (immune), HIV (-).
Differential Diagnoses List
-What in the maternal history puts this infant at risk for health disruptions at the time of delivery?
-How will you prepare for this delivery as the director of care?
-How do you think this infant may present?