A 23-year-old African-American female presents to the clinic for her initial OB visit. She shares that she has recently moved from Atlanta to California to live with family after her divorce. She says she did not know she was pregnant but believes she is about 6 months and reports positive fetal movement. She states she was smoking about ½ a pack of cigarettes a day but when she found out she was pregnant she stopped smoking. She has not received any prenatal care. This is her third pregnancy, her previous pregnancies both delivered early, one at 20 weeks and did not survive, with her second pregnancy she had to stay in the hospital for several weeks and delivered at 32 weeks. That infant survived. Today she complains of back ache that she has had for two days. She is unemployed and is supported by family at present. Her exam reveals: Ht 5’6”, Wt 156, FH 27cm, FHR 152, BP 122/78, positive nitrates in urine and positive bacterial vaginosis by micro.
What lab tests will you order and why?
What diagnostic screening will you order and why? What medications will you prescribe?
What education will you provide?
Please use references that are US Based and can be found on line, peer reviewed, and evidenced based