Hemoglobinopathies in pregnancy Quiz: Ace Your Exams
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A 28-year-old primigravid woman presents to the labor and delivery unit at 16 weeks estimated gestational age with progressively worsening shortness of breath over the past three days. The patient recently immigrated to the U.S. from Thailand and has not received prenatal care. She has had a significant increase in lower extremity swelling recently. She has no chest pain, cough, fever, or calf pain. Past medical history is notable for alpha-thalassemia for which she has received periodic blood transfusions. Temperature is 36.5°C (97.8°F), pulse is 84/min, respirations are 18/min, and blood pressure is 144/86 mmHg. Bibasilar crackles are noted on lung auscultation bilaterally. There is 3+ pitting edema in the lower extremities bilaterally to the knees. Neurologic and obstetric exams are normal. The fetal heart rate is 120/min. Which of the following complications is most likely present?
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