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On examinations, her blood pressure was 150/100 mmHg.Her respiratory rate, pulse rate and temperature were 22/min, 112/min, and 36.8 °C respectively. On abdominal examination, there was a 6 cm by 4 cm mass on left lower quadrant. The mass was smooth, firm and non-tender. Her symphysis fundal height was 28 weeks sized gravid uterus, with longitudinal lie and cephalic presentation. The fetal heart rate was 132 beats per minute and there were no uterine contractions. On vaginal examination the cervix was closed and uneffaced. The presenting part was not accessible and Head was palpable in the posterior cul-de-sac. On ultrasonography examination, Liver looks normal. There was mild right hydronephrosis. There was a singleton intrauterine viable pregnancy, and gestational age was 30 weeks by ultrasound estimation. The FL to AC ratio was 24.2. The Placenta was on the body of uterus anteriorly. There was no measurable amniotic fluid. There was separate empty uterus sharing same myometrium with existing pregnant uterus. Her preoperative hemoglobin was 11.6 mg/dl and platelet count was with in normal limit. Her urine albumin was +2.the renal and liver function tests were with in normal limits. Emergency cesarean delivery was decided with the impression of bicornuate uterus with intrauterine pregnancy, intrauterine growth restriction and sever preeclampsia. Upon opening her abdomen and entering the peritoneum, there was no heamoperitoneum and the fetus was seen in an intact amniotic sac (Fig. 1).
About 2 in 3 neural tube defects can be prevented through increasing folate (folic acid) intake at least a month before pregnancy and during the first 3 months of pregnancy. Adequate folate levels are critical during the early days of the developing embryo, particularly the 3rd and 4th week, the period in which neural tube defects occur and when many women won't know they are pregnant.
Your options for ending your pregnancy will depend on how many weeks pregnant you are when you make the decision. If you decide to end your pregnancy, you may wish to talk to a counsellor afterwards. Your doctor or midwife will be able to arrange this for you.
Inspired by several fictional Republican Senators who share a Washington DC row-house in this political satire with a long list of revered recurring/guest actors (Wanda Sykes, Amy Sedaris, Cynthia Nixon) and cameos from figures including Stephen Colbert, Rachel Maddow and Elizabeth Warren. Julie Carrel (Brooke Bloom) is the chief-of-staff for Senator Louis and her girlfriend, Katherine (Natalie Gold) is chief-of staff to a different senator. They eventually get pregnant! 2b1af7f3a8
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