A 36-year-old woman, gravida 3 para 2, at 15 weeks gestation comes to the office for routine prenatal care

A 36-year-old woman, gravida 3 para 2, at 15 weeks gestation comes to the office for routine prenatal care. The patient has no

vaginal bleeding, leakage of fluid, or cramping She has chronic hypertension controlled by 1 medication. She is taking a daily

prenatal vitamin and does not use tobacco, alcohol, or illicit drugs. Her 2 prior pregnancies were uncomplicated. Blood pressure is

146/90 mm Hg and pulse is 88/min. BMI is 28 kg/m2

• Fetal heart rate is normal. Urinalysis is negative for protein. The first-trimester

combined test results are reviewed with the patient and include an abnormally elevated 13-hCG level as well as a 13-week ultrasound

that shows an increased nuchal thickness but no other abnormalities. Which of the following is the most appropriate next step in

management of this patient?

  • QA Amniocentesis
  • 0 B. Chorionic villus sampling
  • 0 C. Dilation and suction curettage
  • 0 D. Maternal karyotype
  • 0 E. Maternal serum quadruple screen

0 voters