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A 29-Year-Old Woman, Gravida 1 Para 0, at 34 Weeks

question 361

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A 29-year-old woman, gravida 1 para 0, at 34 weeks gestation comes to the office for a routine prenatal visit.  She has had no contractions, vaginal bleeding, or leakage of fluid.  Fetal movement is normal.  The patient has systemic lupus erythematosus with positive anti-Ro/SSA antibodies but has had no flares during this pregnancy.  Her medications include hydroxychloroquine, low-dose aspirin, and a prenatal vitamin.  Blood pressure is 130/88 mm Hg and pulse is 65/min.  Fundal height is 33 cm.  The remainder of the physical examination is unremarkable.  Urine dipstick has trace protein.  A nonstress test is performed for 10 minutes; results are shown in the exhibit.  A 29-year-old woman, gravida 1 para 0, at 34 weeks gestation comes to the office for a routine prenatal visit.  She has had no contractions, vaginal bleeding, or leakage of fluid.  Fetal movement is normal.  The patient has systemic lupus erythematosus with positive anti-Ro/SSA antibodies but has had no flares during this pregnancy.  Her medications include hydroxychloroquine, low-dose aspirin, and a prenatal vitamin.  Blood pressure is 130/88 mm Hg and pulse is 65/min.  Fundal height is 33 cm.  The remainder of the physical examination is unremarkable.  Urine dipstick has trace protein.  A nonstress test is performed for 10 minutes; results are shown in the exhibit.   Which of the following is the most likely etiology for this patient's fetal heart rate tracing? A) Congenital fetal heart block B) Fetal head compression C) Fetal prematurity D) Quiet fetal sleep cycle E) Uteroplacental insufficiencyWhich of the following is the most likely etiology for this patient's fetal heart rate tracing?


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