Efw Case Studies

Nina is a 35yo, G4 P3003, who was seen for an ultrasound evaluation assessment for a VBAC consultation. The patient does have AMA but underwent genetic screening that returned negative by report. We do not have a copy of this to verify. She otherwise denies any major-medical disorders other than some anemia but she is on iron and vitamins for replacement and states overall, she is doing well. Her obstetrical history is significant for 2 vaginal deliveries followed by a cesarean delivery for failure to progress. She states that that child had a very large head but overall is doing above average in school. There are no issues with that child. She is also 42 weeks along. Currently at this time she has no complaints.

By dates using an EDD of 04/09/17, she is 36 1/7 weeks and the fetal measurements on average are 2 weeks larger. The abdominal circumference and femur length are one week larger than dates, whereas the average of the head measurements is 2-3 weeks larger than dates. The current EFW is 3200 g. The amniotic fluid volume is normal, and the BPP and Doppler studies are reassuring. An overview fetal anatomy assessment was performed and no major malformations
We did discuss the fact that the risk for uterine rupture without an evaluation of the LUS for a VBAC in general would be 5 to 7,000, whereas the risk is probably decreased by at least 50% if the LUS measurement appears within normal limits. However, she was told that a uterine rupture cannot be fully excluded because they can occur in patients who have normal transvaginal ultrasound assessments. Again, she is interested in a VBAC because her first 2 were vaginal deliveries. Therefore, we will be in touch with you by phone to work out a schedule for possible delivery. Currently at this time we have not scheduled her back for a follow-up evaluation with