A 31-year-old nulligravida with a body mass index (BMI) of 42 kg/m2 is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling. Prior to the consultation, you highlight to your obstetric trainee that motivational interviewing with nonstigmatizing terminology avoids negative influences on mood and self-esteem, promoting patient uptake of weight management strategies and a healthy lifestyle.

You are seeing a patient referred by her primary care provider for consultation at your tertiary center’s high-risk obstetrics unit. She is a 37-year-old primigravida currently at 13+2 weeks’ gestation with an incidental 7-cm complex right adnexal mass detected last week on routine first-trimester sonography performed at an external center. Although the ultrasound report is not yet available to you, the consultation note confirms a singleton intrauterine pregnancy with normal fetal morphology and low risk of aneuploidy using sonographic markers. Routine serum prenatal investigations are only significant for iron-deficiency anemia.

A 34-year-old G3P2 at 20 weeks’ gestation presents to the A&E (E.R.) department of your tertiary care center with a three-hour history of nausea and vomiting associated with recurrent right upper quadrant pain, no longer alleviated by analgesics.

A 29-year-old primigravida with sickle cell anemia (SCA) is referred by her primary care provider to your tertiary center’s high-risk obstetrics unit for prenatal care of a sonographically confirmed single viable intrauterine pregnancy at 8+2 weeks’ gestation. She has no obstetric complaints.

A 28-year-old nulligravida with known factor V Leiden mutation is referred by her primary care provider to your hospital center’s high-risk obstetrics unit for preconception counseling.

During your obstetric call duty in a tertiary hospital center, you receive a telephone call from a colleague on call duty at a community hospital center where a 34-year-old G3P2 presented with uterine contractions at 27 weeks’ gestation.

A 25-year-old primigravida at 21+5 weeks’ gestation is sent by her primary care provider for urgent consultation and transfer of care to your tertiary center’s high-risk obstetrics unit for increasing diaphoresis, body aches, and anxiousness since self-discontinuation of heroin upon recent knowledge of pregnancy.

During your call duty, a 37-year-old obese G2P1 patient presents to your hospital center’s obstetric emergency assessment unit at 33+3 weeks’ gestation with pain and bruising in the lower aspect of the mid-abdomen. She holds her lower abdomen for support in between bouts of a residual dry cough after completion of antibiotic treatment for community-acquired pneumonia. Pregnancy has otherwise been unremarkable, and she has been compliant with prenatal care. She does not have vaginal bleeding or fluid loss. Two years ago, she had a Cesarean section for term breech presentation.

During your call duty, a 29-year-old primigravida at 19+2 weeks’ gestation by early ultrasound dating presents to the obstetrics emergency assessment unit of your hospital center with a one-week history of dyspnea. She has not refilled her asthma treatments, as she was busy changing residences. The patient converses well, without signs of distress.

A 25-year-old G2P1 presents for prenatal care at 8+2 weeks’ gestation by menstrual dates with complaints of nausea and vomiting for the past two weeks. Your clinical nurse reassures you the patient is not in acute distress and converses well. There is no history of vaginal bleeding.

A 37-year-old nulligravida with a one-year history of well-controlled essential hypertension is referred to your high-risk obstetrics clinic for preconception counseling. Recent comprehensive investigations are free of end-organ dysfunction. Maintaining a healthy lifestyle, she lost weight over the past year; her body mass index (BMI) is now 31 kg/m2. She uses condoms for contraception and is adherent to long-acting nifedipine once daily; folic acid–containing prenatal vitamins were initiated last month.

You are covering the obstetric practice of a colleague who just left on a two-month leave. A 28-year-old primigravida with a spontaneous singleton at 35+1 weeks’ gestation presents for a routine prenatal visit. Pregnancy dating was confirmed by first-trimester sonography. Your trainee informs you the patient is normotensive, fundal height is appropriate for gestation, and she does not have clinical complaints. Fetal activity has been normal. The patient wishes to discuss labor management with you at this visit.

You are covering an obstetrics clinic for your colleague, who left for vacation last week. A healthy 32-year-old primigravida at 13+4 weeks’ gestation called for an emergency appointment after experiencing two episodes of postcoital bleeding over the past week. She met your colleague last week at her first prenatal visit, which was unremarkable. Sonographic dating was appropriate for menstrual age, and first-trimester fetal anatomy was normal. You note that all routine prenatal serum laboratory investigations are normal with low-risk screening tests for fetal aneuploidy. Without a cervical smear in over two years, cytology was performed, and results are expected shortly.

A 29-year-old G1P0 at 32 weeks’ gestation is brought in by ambulance to the A&E (E.R.) department in your tertiary trauma center following a road traffic accident. She was the restrained driver of a vehicle driving on an icy road at around 50 mph (80 km/h), when she lost control and had a frontal impact collision with another vehicle. She is healthy and has had an unremarkable pregnancy to date. On arrival, she is alert but appears anxious and uncomfortable. Her cervical spine is immobilized with a cervical collar and blocks, and she is on a spinal board. She complains of pains in her chest and lower abdomen. There is a bruise across her right forehead. Her vital signs show a sinus tachycardia of 115 bpm, blood pressure 87/62 mmHg, pulse oximetry 94% on room air, respiratory rate 28/min, and core temperature of 34.6°C. You are covering the birthing center and have been called urgently to the A&E department to assist in the management of this patient.

During your call duty, a healthy 40-year-old primigravida with a spontaneous dichorionic pregnancy presents, accompanied by her husband, to the obstetric emergency assessment unit of your hospital center at 33+1 weeks’ gestation with new-onset abdominal pain and vomiting after a two-day history of nausea and general malaise. She has no obstetric complaints, and fetal viabilities are ascertained upon presentation. Her face appears yellow tinged relative to her last clinical visit one week ago. You recall that routine prenatal laboratory investigations, aneuploidy screening, morphology surveys of the male fetuses, and serial sonograms have all been unremarkable.

During your obstetric call duty in a tertiary hospital center, you receive a telephone call from a colleague at an external center for an incidental isolated platelet count of 69 × 109/L in a 22-year-old primigravida with a singleton pregnancy at 24+3 weeks’ gestation by early dating sonography. The full/complete blood count (FBC/CBC) was performed to follow up on iron-deficiency anemia. Fetal activity is normal.

You are seeing a new patient in consultation for transfer of care to your high-risk obstetrics unit at a tertiary center. She is a 27-year-old primigravida at 14+3 weeks’ gestation with an incidentally positive surface antigen to the hepatitis B virus (HBsAg) on routine prenatal testing. A copy of the original laboratory report has been provided to you. Although detailed serological investigations were performed, results are not available. The patient is aware of the results. Referral to a hepatologist has also been instigated. The patient’s first-trimester sonogram and aneuploidy screen were unremarkable. She has no obstetric complaints.

A 26-year-old G2P1 with Crohn’s disease (CD) is referred by her primary care provider to your high-risk obstetrics unit for transfer of care at 10 weeks’ gestation by dating sonography. Routine prenatal investigations are unremarkable. She has no obstetric complaints.