Discussing tests available in early pregnancy - GP

CurtinYear 510 min + 2 min readingWomen's health & obstetricsStandardPre-internship
  • Focused history
  • Informed consent

Ready

2 min reading, 10 min station, warning at 2 min

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Station - Instructions for candidate

You are a junior doctor working in a general practice in Perth.

Maricel Reyes, a 33-year-old musician, is 10 weeks into her first pregnancy, confirmed at the practice three weeks ago when routine antenatal bloods were requested. She has booked today because a friend told her about 'the tests you can have for the baby' and she wants to understand her options before her dating scan next week. The practice nurse has recorded her observations.

Observations (practice nurse)BP 108/68 mmHg, HR 80 /min, weight 58 kg, BMI 22 kg/m2
From the fileG1P0, 10 weeks by last menstrual period, dating ultrasound booked next week. Routine antenatal bloods requested at the last visit; results pending. Taking folate and iodine. No medical history. No medicines. No known allergies.

Your tasks are to:

  1. Take a focused history relevant to the decision she is making.
  2. Explain the tests available in early pregnancy to look for chromosomal conditions in the baby, so that she can make an informed choice: what each involves, what it can and cannot tell her, timing, cost, and what would follow a high-chance result.
  3. Support her to reach a decision that is right for her, and agree the next steps.
  • You do NOT need to examine the patient.
  • You do NOT need to summarise your findings to the examiner.
  • You do not need to discuss the routine antenatal bloods or the 20-week scan in detail, or complete any request forms.

This is a 10-minute station, with 2 minutes of reading time.

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