CASE PRESENTATION
Rh NEGATIVE PREGNANCY
PRESENTATION BY-
Lakshmi Sudhanshu
Final Year
AFMC
PATIENT PARTICULARS
Mrs xyz
29 year old
Resident of Kondhwa
Occupation: Housemaid
Educated till Class 8th HUSBAND
• Mr xyz 31 yr Old
Blood group : B-ve
•Blood group : B+ve
Married for 5 years • Occupation: Farmer
Socio Economic Status: Low Socioeconomic Status
(Modified Kuppuswamy scale)
Informant Self; Reliability Good
LMP: 28 July, 2020
EDD: 24 April, 2021
POG: 10 weeks, 01 day
G3P1L1A1
She has come with 10 weeks of amenorrhea
for her first antenatal visit and is currently
asymptomatic.
History of present pregnancy
Spontaneous conception
1st trimester
diagnosed by UPT
USG: Confirmed Pregnancy
Routine ANC investigations have been advised;
reports awaited
No h/o excessive nausea and vomiting
No h/o fever with rashes
No h/o bleeding PV or discharge PV
No h/o pain abdomen
No h/o burning micturition, increased frequency of micturition
No history of radiation or teratogenic drug exposure
No easy fatigability
Obstetric History
Married since 05 year
Non-consanguineous marriage
She is Multigravida, G3P1L1A1
Currently at 10wk 01 days POG
No. Date of Antenat Labor Method puerperium baby
Pregna al period events of
ncy delivery
1. 2016 _ _ Full term h/o costly Baby 2.8
(at 25 uneventf Normal injection Kg
yrs of ul vaginal administration Cried at
age) delivery on 3rd day in the birth,
upper arm Live and
healthy
2. 2018 Spontane Spontane Was managed in
(at 27 ous ous village
yrs of abortion conceptus No h/o
age) at 3rd delivery prophylactic
month antiD was given
post abortion
Menstrual history
Age of menarche: 13 years
Past cycles: Regular, 28-30days - followed by 3-4
days of menses
Not associated with dysmenorrhea or passage of
clots
PAST HISTORY
No major medical problem like HTN, DM, TB,
Asthma, Thyroid disorders, Epilepsy, Bleeding
Problems, or Drug treatment history.
No surgical history
No h/o blood transfusion
Family history
No history of diabetes, hypertension, asthma, Tb,
blood dyscrasia, known hereditary disease in the
family
No h/o children with congenital malformations
No h/o twinning
Personal history
No contraceptive used
Diet: Mixed
◦ Calories required =2,500 kcals
◦ Calories intake = 2,100kcals
◦ Protein intake: adequate
◦ Calorie Deficit = 18%
Appetite : Good
Sleep / wake cycle : normal
Bowel and bladder : regular
No h/o any substance abuse, Smoking, alcohol intake or
high risk behaviour
No h/o any known drug allergy
SUMMARY:
29 year old blood group B-ve multigravida, G3P1L1A1,
at 10 wk 01 day period of gestation, married to B+ ve
husband; spontaneous conception, presented for
routine ANC visit and currently asymptomatic, with no
other co morbidities and no significant family history.
General Physical Examination
Patient is conscious, co-operative and well oriented to time ,
place and person. Patient is moderately built and nourished.
Consent was taken and examined in presence female attendant
Vitals :
◦ Patient is afebrile
◦ Pulse rate : 82 Beats/min in right radial artery which is regular in rhythm,
good volume , normal in character, no vessel wall thickening, equal on
both sides , no radioradial or radiofemoral delay and all the peripheral
pulses were palpable
BP: 120/74 mmHg
Respiratory rate : 16 breaths /min
JVP: not raised
Mild Pallor present,
No Icterus, Clubbing, Cyanosis, Lymphadenopathy, Pedal Edema
BMI : 24.14kg/m2
◦ Height : 155cms
◦ Weight : 58kgs (Prepregnancy weight)
Gait and spine appeared to be normal
Orodental hygiene well maintained and no signs of
nutritional deficiencies
No dilated veins over the neck
Thyroid appears normal
Breast- normal, no retracted or cracked nipples and no
palpable lump
Systemic examination
CNS Examination:
◦ No Focal Neurological Deficits
Respiratory System Examination:
◦ Bilaterally equal air entry, Vesicular breath sounds in all
areas of lung, no adventitious sounds
Cardiovascular Examination
◦ S1 and S2 heard, no murmur
◦ No parasternal heave/ thrills palpated
Abdominal examination
◦ Striae albicans seen
◦ Bowel sounds- present, normoactive in all four
quadrants
SUMMARY:
29 year old multigravida, G3P1L1A1, at 10 wk 01 day
period of gestation; spontaneous conception, blood
group B-ve married to B+ve husband, h/o 1st term
abortion (details unknown), presented for routine
ANC visit and currently asymptomatic.
On examination, mild pallor was seen, and no other
abnormal finding was there.
Provisional diagnosis
A 29 years old lady is G3P1L1A1 at 10 weeks 01 day of
gestation, blood group B-ve married to B+ve husband,
h/o 1st term abortion (details unknown), presented for
routine ANC checkup, with normal examination
findings highly suggestive of Rh incompatibility risk in
present pregnancy.
