Rh negative Pregnancy pptx

Vihvinvi

1. CASE PRESENTATION Rh NEGATIVE PREGNANCY PRESENTATION BY- Lakshmi Sudhanshu Final Year AFMC

2. PATIENT PARTICULARS Mrs xyz 29 year old Resident of Kondhwa Occupation: Housemaid Educated till Class 8 th Blood group : B- ve Married for 5 years Socio Economic Status: Low Socioeconomic Status (Modified Kuppuswamy scale) Informant Self; Reliability Good HUSBAND Mr xyz 31 yr Old Blood group : B+ve Occupation: Farmer

3. LMP: 28 July, 2020 EDD: 24 April, 2021 POG: 10 weeks, 01 day G 3 P 1 L 1 A 1 She has come with 10 weeks of amenorrhea for her first antenatal visit and is currently asymptomatic .

4. History of present pregnancy Spontaneous conception 1 st trimester diagnosed by UPT USG: Confirmed Pregnancy Routine ANC investigations have been advised; reports awaited

5. No h/o excessive nausea and vomiting No h/o fever with rashes No h/o bleeding PV or discharge PV No h/o pain abdomen No h/o burning micturition , increased frequency of micturition No history of radiation or teratogenic drug exposure No easy fatigability

6. Obstetric History Married since 05 year Non-consanguineous marriage She is Multigravida , G 3 P 1 L 1 A 1 C urrently at 10wk 01 days POG

7. No. Date of Pregnancy Antenatal period Labor events Method of delivery puerperium baby 1. 2016 (at 25 yrs of age) _ uneventful _ Full term Normal vaginal delivery h/o costly injection administration on 3 rd day in the upper arm Baby 2.8 Kg Cried at birth, Live and healthy 2. 2018 (at 27 yrs of age) Spontaneous abortion at 3 rd month Spontaneous conceptus delivery Was managed in village No h/o prophylactic antiD was given post abortion

8. Menstrual history Age of menarche: 13 years Past cycles: Regular, 28-30days - followed by 3-4 days of menses Not associated with dysmenorrhea or passage of clots

9. PAST HISTORY No major medical problem like HTN, DM, TB, Asthma, Thyroid disorders, Epilepsy, Bleeding Problems, or Drug treatment history. No surgical history No h/o blood transfusion

10. Family history No history of diabetes, hypertension, asthma, Tb, blood dyscrasia , known hereditary disease in the family No h/o children with congenital malformations No h/o twinning

11. Personal history No contraceptive used Diet: Mixed Calories required =2,500 kcals Calories intake = 2,100kcals Protein intake: adequate Calorie Deficit = 18% Appetite : Good Sleep / wake cycle : normal Bowel and bladder : regular No h/o any substance abuse, Smoking, alcohol intake or high risk behaviour No h/o any known drug allergy

12. SUMMARY: 29 year old blood group B- ve multigravida , G 3 P 1 L 1 A 1 , at 10 wk 01 day period of gestation, married to B+ ve husband; spontaneous conception, presented for routine ANC visit and currently asymptomatic, with no other co morbidities and no significant family history.

13. General Physical Examination Patient is conscious, co-operative and well oriented to time , place and person. Patient is moderately built and nourished. Consent was taken and examined in presence female attendant Vitals : Patient is afebrile Pulse rate : 82 Beats/min in right radial artery which is regular in rhythm, good volume , normal in character, no vessel wall thickening, equal on both sides , no radioradial or radiofemoral delay and all the peripheral pulses were palpable

14. BP: 120/74 mmHg Respiratory rate : 16 breaths /min JVP: not raised Mild Pallor present, No Icterus , Clubbing, Cyanosis, Lymphadenopathy , Pedal Edema BMI : 24.14kg/m 2 Height : 155cms Weight : 58kgs ( Prepregnancy weight ) Gait and spine appeared to be normal

15. Orodental hygiene well maintained and no signs of nutritional deficiencies No dilated veins over the neck Thyroid appears normal Breast- normal, no retracted or cracked nipples and no palpable lump

16. Systemic examination CNS Examination: No Focal Neurological Deficits Respiratory System Examination: Bilaterally equal air entry, Vesicular breath sounds in all areas of lung, no adventitious sounds

17. Cardiovascular Examination S1 and S2 heard, no murmur No parasternal heave/ thrills palpated Abdominal examination Striae albicans seen Bowel sounds- present, normoactive in all four quadrants

18. SUMMARY : 29 year old multigravida , G 3 P 1 L 1 A 1 , at 10 wk 01 day period of gestation; spontaneous conception, blood group B- ve married to B+ve husband, h/o 1 st term abortion (details unknown), presented for routine ANC visit and currently asymptomatic. On examination, mild pallor was seen, and no other abnormal finding was there.

19. Provisional diagnosis A 29 years old lady is G 3 P 1 L 1 A 1 at 10 weeks 01 day of gestation, blood group B- ve married to B+ve husband, h/o 1 st term abortion (details unknown), presented for routine ANC checkup, with normal examination findings highly suggestive of Rh incompatibility risk in present pregnancy.