Jacquline Case Study

Jacquline is a 25yo, G3 P2002, who is currently 28 weeks 3 days. She is being followed through our office due to a notable history of postpartum cardiomyopathy. She had an ECHO at the beginning of pregnancy and a repeat ECHO which was 5 days ago that also showed an ejection fraction of 60%. She has some shortness of breath which is likely related to pregnancy and her difficulty ambulating secondary to left foot surgery. Essentially, she had a clubfoot that had difficulty healing and required several reconstructive surgeries. She has an orthopaedic surgeon, Dr. James Engblom, in Oneida but he does not see her during pregnancy. She has had some significant pain in the left foot as the screw appears to be working its way out. Because of this, ambulating can be quite difficult and the pain causes her difficulty as well. She also has a history of depression but recently stopped her Wellbutrin and feels that she is overall able to tolerate things.

Fetal biometry is consistent with dates. A limited survey was unremarkable. Fluid and Doppler’s are overall reassuring and BPP is 8/8.

Jacquline and I discussed several issues today. I did review her ECHO report that she had not heard from and we are very pleased with the normal ejection fraction. We also discussed her foot. I will try to get her an orthopaedic surgeon here at UT who may be willing to look at her foot while she is pregnant. I did order a left foot x-ray in the event that this may help them make decisions and we will get her a referral here at UT for an orthopaedic surgeon. She is otherwise scheduled to return in 4 weeks in our office for ongoing evaluation of fetal growth due to a history of postpartum pericardium cardiomyopathy.

Thank you for referring this patient to our office. Please do not hesitate to call us if you have any