A 28-year-old nulligravida with Marfan syndrome is referred to your tertiary center’s high-risk obstetric unit for preconceptional counseling. She has no other medical issues.

During your call duty, a healthy 32-year-old primigravida at 22+3 weeks’ gestation, confirmed by first-trimester sonography, presents to the obstetrics emergency assessment unit of your hospital center with new-onset, asymptomatic port-wine-colored urine with chills and an oral temperature of 39.1°C at home; she also notes a two-day history of headache, now accompanied by visual changes. Your obstetric trainee informs you that clinical history is not suggestive of an infectious etiology, although comprehensive investigations are pending. She has no obstetric complaints, and fetal viability was ascertained upon presentation. Routine prenatal laboratory investigations, aneuploidy screening, and fetal morphology survey were unremarkable. The laboratory urgently notifies you that the platelet concentration is 12 × 109/L, confirmed on manual count; other requested laboratory tests are in progress.

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.

A 33-year-old primigravida on thrice weekly hemodialysis while awaiting renal transplantation is referred by her nephrologist to your high-risk obstetric unit. Given irregular menstrual cycles, she did a home urine pregnancy test after three months of amenorrhea. Yesterday, she was pleasantly surprised with dating sonography confirming a single viable intrauterine fetus at 11+1 weeks’ gestation. The request for consultation ensures that her nephrologist, nutritionist, and other allied members in dialysis care will follow her pregnancy with you.

A healthy 27-year-old G1P0 at 10+3 weeks’ gestation, confirmed by sonography two days ago, presents for prenatal care. She arrived last month from overseas and currently lives with her sister and nephew, who has been home from daycare with German measles.

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.

A healthy 27-year-old G2P1 patient immigrated from Barbados last week. Her first appointment with you is in two days. She calls your office now concerned about her pregnancy, as her three-year-old son has chickenpox. She is currently at 15+2 weeks’ gestation by early dating sonography, which she had in her native country; routine prenatal investigations and aneuploidy screen were normal. Recent HIV testing was negative. She had a prior healthy pregnancy and term vaginal delivery.

A new patient presents for consultation and transfer of care to your high-risk obstetrics unit at a tertiary center. She is a healthy 22-year-old primigravida at 14+3 weeks’ gestation with an incidentally positive test for human immunodeficiency virus (HIV) on routine prenatal testing. A copy of the original laboratory report has been provided to you. The patient is aware of the results. Referral to a virologist has also been instigated. Her first-trimester sonogram and aneuploidy screen were unremarkable. She has no obstetric complaints.

A 37-year-old G1P1 with a three-year history of type 2 diabetes mellitus (T2DM) is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling. Six years ago, she delivered her son at another hospital center.

During your call duty, a 25-year-old primigravida with a 12-year history of type I diabetes mellitus (T1DM) at 26+1 weeks’ gestation by early sonographic dating of an unplanned pregnancy is accompanied by her husband to the obstetric emergency assessment unit at 4:00 AM for a three-hour history of nausea followed by recurrent nonbilious vomiting. Despite the lack of oral intake since her standard bedtime snack, her husband indicates the patient passed urine at least five times over the last hour, as he assisted her due to drowsiness and visual blurring.

A healthy 38-year-old secundigravida presents for a first prenatal visit after sonography at your hospital center just dated a spontaneous intrauterine pregnancy at 12+4 weeks’ gestation. Early fetal morphology and sonographic screening markers for aneuploidy are unremarkable. You learn that she and her husband just moved to the country. Five years ago, she had gestational diabetes mellitus (GDM) and delivered vaginally. The patient has no obstetric complaints and has been taking folate-containing prenatal vitamins. She does not drink alcohol, smoke cigarettes, or use any recreational substances.

A 29-year-old primigravida is referred by her primary care provider to your tertiary center’s high-risk obstetrics unit for preconception counseling for known Graves’ disease.

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.

A 28-year-old nulligravida is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling for known systemic lupus erythematosus (SLE).

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.

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 27-year-old primigravida at 16+3 weeks’ gestation with intermittent swelling of her arms and face that appears within several minutes of brushing her hair and resolves upon lowering her arms. First-trimester dating sonography was concordant with menstrual dates, and fetal morphology appeared normal, with a low risk of aneuploidy; apart from HIV-negative status, results of other routine baseline prenatal investigations are not yet available to you. She has not experienced abdominal cramps or vaginal bleeding. Her medications include only routine prenatal vitamins.

A 32-year-old primigravida at 16+1 weeks’ gestation is referred by her primary care provider to your high-risk obstetrics unit at a tertiary center for evaluation of a breast lump. Routine prenatal investigations, fetal sonography, and aneuploidy screening were normal. The patient does not have any obstetric complaints and takes only prenatal vitamins.