A 29-Year-Old Primigravida at 30 Weeks Gestation Comes to the Office

question 261

Multiple Choice

A 29-year-old primigravida at 30 weeks gestation comes to the office accompanied by her husband.  She is concerned that she has not felt the baby move or kick for the past day.  The pregnancy was planned, and her prenatal tests and fetal growth have been normal.  The patient has no chronic medical conditions and takes a prenatal vitamin daily.  On ultrasound, no fetal heartbeat is detected.  The physician informs the parents about the loss of the fetus.  They appear to be in shock, and the patient cries, "I can't believe this is happening.  I was following all the recommendations, and I only missed one appointment.  I should have come in sooner."  Which of the following is the most appropriate response by the physician?

• A)"I know this is very distressing; you will get through this and feel better in time."
• B)"I'm sorry for your loss; we will need to discuss an induction of labor as soon as possible."
• C)"I'm sorry you have to go through this, but there is every reason to expect a healthy baby in the future."
• D)"There's nothing you did wrong; let's discuss the options you have for further testing."
• E)"Unfortunately, there is a chance of fetal loss in all pregnancies, even healthy ones."
• F)"You did everything you could for your baby, and this loss was not your fault."

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Definitions:

Cases

Instances or occurrences of a particular condition or category being studied or reported.

Categorical

Refers to a type of data that can be divided into groups or categories that are mutually exclusive.

Variable

An element, feature, or factor that is liable to vary or change, the values of which can differ in a dataset or experiment.

Key Characteristic

An attribute or feature that is deemed essential or significantly important.