Step 2

Obstetrics 1

A 31-year-old woman presents for obstetrical care for the first time and is found to be at 28 weeks’ gestation. She has no current complaints but reports a history of photosensitive malar rash, polyarthritis, cold fingers, and depression. She takes hydroxychloroquine and low-dose prednisone. Physical examination is unremarkable except for a gravid uterus, painless aphthous ulcer in the mouth, and mild Raynaud phenomenon in the distal fingers bilaterally. Fetal auscultation reveals bradycardia. Laboratory evaluation of the patient reveals a mild microcytic anemia, positive antibody titers for antinuclear, anti-dsDNA, anti-Ro/SSA, and anti-La/SSB antibodies.

Which of the following interventions is most likely to be required for the infant after birth?

  • A) Administration of intravenous indomethacin
  • B) Administration of surfactant
  • C) Evaluation for renal transplantation
  • D) Initiation of lifelong anticoagulation
  • E) Placement of a cardiac pacemaker

Authors

John Damianos

Editor

Dr. Ted O’Connell

Last updated

Feb 11, 2024

Source

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