Prenatal Visit

G2P1001. EDD: July 15, 2026 (dating consistent between LMP and 1st trimester ultrasound). Prenatal care began at 8 weeks. This pregnancy uncomplicated thus far.

LMP: October 20, 2025. Dating US at 11w3d confirmed EDD.

Previous prenatal visits at 12w (initial), 16w (quad screen), 20w (anatomy scan), 24w (glucose challenge), and today 28w5d (routine).

Reports fetal movement felt regularly since 18 weeks, now feeling strong kicks and rolls throughout the day. Kick counts consistently >10 in 2-hour periods. No vaginal bleeding, leakage of fluid, or contractions. Some lower back discomfort and pelvic pressure, attributed to growing uterus. Mild pedal edema at end of day, resolves overnight. Sleeping reasonably well with body pillow. Mood stable. No headaches, visual changes, or epigastric pain.

BP: 118/72 (stable, baseline 114-120/68-76 range)

Weight: 156 lb (+2 lb since last visit, total gain: 18 lbs)

HR: 76 regular

Urinalysis: negative for protein, glucose, leukocytes, nitrites

28 cm (consistent with gestational age, 50th percentile). Fetal lie: longitudinal. Presentation: cephalic (by Leopold maneuvers). Fetal back left posterolateral.

145 bpm, regular. Doppler auscultation. Good variability appreciated subjectively.

Glucose Challenge Test (24w): 118 mg/dL (PASS, <140 threshold)

Anatomy Ultrasound (20w): Normal anatomy. Placenta: anterior, 2.8 cm from internal os (low-lying but NOT placenta previa — margin will be reassessed at 32w). Amniotic fluid: adequate (AFI 12 cm). EFW: 50th percentile.

Quad Screen (16w): Low risk for Trisomy 21, 18, and NTD.

First trimester screen (12w): Combined screen low risk.

HIV, Hep B, Syphilis, Rubella: all non-reactive/immune as appropriate.

Blood type: A positive, antibody screen negative.

1. Routine prenatal care continues — next visit scheduled for 32 weeks

2. Repeat anatomy/transvaginal ultrasound at 32w to confirm placental position away from os

3. Tdap vaccine: administer today (27-36 week window) — provide cocooning education for household contacts

4. Rhogam: not indicated (Rh positive)

5. Start discussing signs of preterm labor, warning symptoms (severe headache, visual changes, epigastric pain, sudden swelling)

6. Prenatal vitamins: continue daily

7. Calcium supplementation: 1000 mg elemental calcium daily (recommended for preeclampsia prevention)

8. Kick count instructions reinforced — report if <10 movements in 2 hours

9. Birth plan discussion at next visit — review delivery preferences, epidural consideration, cord blood banking decision