Fetal growth restriction Quiz: Ace Your Exams
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A 37-year-old woman, gravida 4, para 3, presents for routine prenatal care at 36 weeks estimated gestational age (EGA), dated by her last menstrual period. The pregnancy has been complicated by a chronic placental abruption following a motor vehicle accident six weeks ago. The patient reports occasional light spotting, but no contractions, loss of fluid, or decreased fetal movement since her last appointment 2 weeks ago. Past medical history is notable for three prior spontaneous vaginal deliveries at term, and she is taking a prenatal vitamin. Pre-pregnancy body mass index was 26 kg/m2, and she has gained 18 lb. (8.2 kg) this pregnancy. Temperature is 36.7°C (98.1°F), pulse is 79/min, respirations are 18/min, and blood pressure is 115/75 mmHg. On exam, the abdomen is non-tender, and the fundal height is 32 cm. Results from a growth ultrasound obtained today are shown in the table. Which of the following is the most appropriate next step in management?
| Fetal growth parameter | Result |
| Estimated fetal weight | 18th percentile |
| Biparietal diameter | 20th percentile |
| Head circumference | 24th percentile |
| Abdominal circumference | 8th percentile |
| Femur length | 15th percentile |
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