Hemoglobinopathies in pregnancy Quiz: Ace Your Exams
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A 34-year-old primigravid woman presents for a routine antenatal appointment at 12 weeks estimated gestational age. She has no symptoms today other than feeling more tired than usual. The patient has a history of heavy menstrual bleeding related to a small uterine fibroid. She is a history professor and does not use alcohol, tobacco, or recreational drugs. She is of Egyptian descent. Vital signs are within normal limits. The physical exam shows the uterus is enlarged to a 13-week size, the cervical os is closed, and there is normal physiologic discharge present. There is no pallor, jaundice, or hepatosplenomegaly. The results of first-trimester antenatal screening labs are shown in the table below. Which of the following is the best next step in management?
| Laboratory value | Result |
| Hemoglobin | 10.3 g/dL |
| Hematocrit | 31 % |
| Leukocyte count | 6,100 /mm3 |
| Platelet count | 213,000/mm3 |
| Mean corpuscular volume | 76 fL |
| Serum ferritin | normal |
| Total-iron-binding capacity | normal |
| Hemoglobin electrophoresis | normal |
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