During your overnight call duty, a 37-year-old G2P1 with a spontaneous pregnancy presents to the obstetrics emergency assessment unit of your tertiary center at 32+3 weeks’ gestation with pruritis preventing her from sleep. She has no obstetric complaints; cardiotocography initiated upon the patient’s presentation shows a normal fetal heart tracing and uterine quiescence.

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 G2P1 at seven weeks’ gestation is referred to your tertiary center for consultation and prenatal care. Obstetric history is significant for fetal growth restriction (FGR) requiring preterm delivery at 33 weeks’ gestation. Her son’s birthweight was 1400 g. The patient’s prenatal care and delivery were at another center, and her medical chart is unavailable at the time of initial consultation.

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.

During your call duty, a 38-year-old G5P4 with a spontaneous dichorionic pregnancy presents to the obstetric emergency assessment unit of your tertiary center at 37+5 weeks’ gestation with dyspnea and noticeable bilateral leg edema. She has no obstetric complaints. Your colleague follows her prenatal care. Routine prenatal laboratory investigations, aneuploidy screening, fetal morphology surveys, and serial sonograms have all been unremarkable. She had four uncomplicated pregnancies and term vaginal deliveries in your hospital center.

A 21-year-old G1P1 with an uncomplicated pregnancy and vaginal delivery presents to your obstetrical assessment unit one week postpartum with concerns regarding the care of her newborn. She informs the nurse of difficulty with breastfeeding, which triggers a sense of worthlessness. The patient also complains of sleeplessness, even when the baby is asleep, and thereby is constantly exhausted. She shares with the nurse that she is ‘worried all the time about everything’ and finds herself crying randomly throughout the day for no apparent reason. The patient complains of intense ‘mood swings,’ which have led to frequent argumentation with her partner.

A 35-year-old G2P1 with chronic hypertension is referred by her primary care provider to your tertiary-care center for prenatal care of a singleton intrauterine pregnancy at 8+2 weeks’ gestation by dating sonography. The patient has no obstetric complaints to date. Her last pregnancy was 10 years ago.

During an obstetrics call duty in your tertiary center, you are called urgently to assist in a Cesarean section of a 42-year-old with sudden intraoperative maternal collapse. Your surgical colleague followed her prenatal care.

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 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 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.

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.

A 23-year-old primigravida is referred for consultation at 21+5 weeks’ gestation with a new onset of genital lesions. Her referring physician informs you that she has no history of genital herpes and that her obstetric progress has been unremarkable. All routine prenatal screening tests and investigations have been normal. She has no obstetric complaints and indicates the fetus is active.

A 30-year-old G6P2A4L1 is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling after a pregnancy loss at 21+4 weeks’ gestation last year, shortly after incidental transvaginal cervical shortening was noted at second-trimester fetal morphology survey. After an uncomplicated first pregnancy and term delivery, she experienced four consecutive first-trimester losses for which comprehensive investigations were unremarkable.

A healthy 23-year-old G2P1 presents for prenatal care at 12+0 weeks’ gestation by dating ultrasound. Her last pregnancy was cared for by your colleague, who is currently away. Pregnancy was uncomplicated, and she had a spontaneous vaginal delivery at term. You learn from the antenatal notes that the patient had a flu-like illness in early pregnancy; investigations were unremarkable, and symptoms resolved with supportive care. She tells you her healthy two-year-old son has been attending daycare since six months of age and is meeting his developmental milestones.

A 37-year-old G6P3A2 at 20+3 weeks’ gestation is referred from a community hospital center for consultation at your tertiary center’s high-risk obstetrics unit for ‘anterior placenta previa with abnormal features’ reported on ultrasound evaluation of the morphologically normal female fetus. First-trimester sonography performed in the same center, integrated with maternal serum biomarkers, revealed a low risk of fetal aneuploidy.

A new patient presents for consultation and transfer of care to your high-risk obstetrics unit at a tertiary center. She is a 34-year-old G4P2A1L2 at 14+3 weeks’ gestation with anti-c antibodies detected on routine testing; results have been confirmed at your hospital’s laboratory. All other prenatal investigations are unremarkable, including first-trimester sonogram and aneuploidy risk assessment.

During an obstetrics call duty in your tertiary center, you are called urgently to assist in the management of vaginal bleeding in a 42-year-old G7P5A2 after recent vaginal delivery of dichorionic twins at term. Although your colleague was anticipating delivery in the operating room/theater, deliveries occurred in the labor suite. Due to a concurrent emergency, the obstetrician has just stepped out of the patient’s room, leaving the junior trainee to continue assisting you in the care of this patient.

You are covering an obstetrics clinic for your colleague who left for vacation. A 30-year-old G2P1 at 37+2 weeks’ gestation by first-trimester sonogram presents for a prenatal visit. Screening tests revealed a male fetus with a low risk of aneuploidy and a normal second-trimester morphology sonogram. Maternal investigations were unremarkable in the first trimester. Your colleague’s note from a second-trimester prenatal visit details the counseling provided with regard to prior shoulder dystocia; a recent note indicates the intent to review management during this visit.