create a power point presentation for maternal medicine MDT meeting. 35yrs, P1 +1 prev NVD 2022 at term+2. 48thcentile, f/b one first trimester miscarriage last year, BMI 21.6, booking bloods normal, low ferritin 10, started don oral iron, MLC otherwise.At 33+2/40 on 1/8/26 , attended AAU for OC bloods as itching hands and feet. Bloods reviewed on 3/8 ( woman was 33+4/40) Raised ALT 648, bile acids 53 noted. Pt Called in to be reviewed by Reg in AAU same day : PET bloods done, PLGF ratio sent, CTG and growth scan. Pt reporting itching for last 4 days on hands and feet and felt very unwell for 2 weeks in mid July after returning from Italy, contacted triage, her symptoms were attributed to anemia, felt very exhausted, loss of appetite, yellowish discolouration of urine. Her repeat bloods done ALT 670, bile acids 40 with liver ultrasound, liver serology, liver auto antibodies. uPCR 43. PLGF ratio, PET bloods normal, normotensive. Growth scan normal (growth t 53rd gentile, normal LV/dopplers). Happy with FM. Differentials at this stage: PET, OC, hepatitis/viral. Referred to AN urgency clinic where she was seen by the consultant at 34/40. OnGoing itching hands and feet, normotensive, Hepatitis A antibody positive, rest of teh hepatitis profile -ve. PT/APTT low, US liver: mild splenomegaly, rest all normal. Differential at this stage: OC, ?recovering from hepatitis A infection. HSV serology sent. (She had herpes infection 10 yrs ago). Urgent referral sent to mat med clinic. Repeat bloods in AAU arranged , growth scan in 2 weeks . Repeat ALT 793, bile acids 25, PLGF ratio normal 4. Telephone review in Consultant clinic to discuss further raising ALT, pt feeling well in herself, managed to do her house chores, happy with FM, HSV serology awaited. Repeat bloods arranged for next day in AAU, CTG , doctors review and discuss with gastro. Discuss with mat med for ongoing plan if ALT rising further. Seen in AAU on 10/8/26: CTG normal, no pain/bleeding, itching gone worse in the last few days. Bloods slightly improved (ALT 676, Bile acid 18 - 10/8/26, CRP 3 , U & E normalPT slightly low 9.3, APTT normal, uPCR 38). Bloods reviewed by Mat med consultant. TORCH screen advised and sent. Referral to hepatologist sent. Liver screen requested. CMV Ig M came back positive. CMV IgG antibody +ve, CMV IgG avidity low. Consistent with recent primary CMV infection (less than 3 months ago). She is 35/40 today. Parvovirus not back yet. Liver autoantibody screen has com back negative. I want you to create a good comparison of LFTs in a table.
create a power point presentation for maternal medicine MDT meeting. 35yrs, P1 +1 prev NVD 2022 at term+2. 48thcentile, f/b one first trimester miscarriage last year, BMI 21.6, booking bloods normal, low ferritin 10, started don oral iron, MLC otherwise.At 33+2/40 on 1/8/26 , attended AAU for OC bloods as itching hands and feet. Bloods reviewed on 3/8 ( woman was 33+4/40) Raised ALT 648, bile acids 53 noted. Pt Called in to be reviewed by Reg in AAU same day : PET bloods done, PLGF ratio sent, CTG and growth scan. Pt reporting itching for last 4 days on hands and feet and felt very unwell for 2 weeks in mid July after returning from Italy, contacted triage, her symptoms were attributed to anemia, felt very exhausted, loss of appetite, yellowish discolouration of urine. Her repeat bloods done ALT 670, bile acids 40 with liver ultrasound, liver serology, liver auto antibodies. uPCR 43. PLGF ratio, PET bloods normal, normotensive. Growth scan normal (growth t 53rd gentile, normal LV/dopplers). Happy with FM. Differentials at this stage: PET, OC, hepatitis/viral. Referred to AN urgency clinic where she was seen by the consultant at 34/40. OnGoing itching hands and feet, normotensive, Hepatitis A antibody positive, rest of teh hepatitis profile -ve. PT/APTT low, US liver: mild splenomegaly, rest all normal. Differential at this stage: OC, ?recovering from hepatitis A infection. HSV serology sent. (She had herpes infection 10 yrs ago). Urgent referral sent to mat med clinic. Repeat bloods in AAU arranged , growth scan in 2 weeks . Repeat ALT 793, bile acids 25, PLGF ratio normal 4. Telephone review in Consultant clinic to discuss further raising ALT, pt feeling well in herself, managed to do her house chores, happy with FM, HSV serology awaited. Repeat bloods arranged for next day in AAU, CTG , doctors review and discuss with gastro. Discuss with mat med for ongoing plan if ALT rising further. Seen in AAU on 10/8/26: CTG normal, no pain/bleeding, itching gone worse in the last few days. Bloods slightly improved (ALT 676, Bile acid 18 - 10/8/26, CRP 3 , U & E normalPT slightly low 9.3, APTT normal, uPCR 38). Bloods reviewed by Mat med consultant. TORCH screen advised and sent. Referral to hepatologist sent. Liver screen requested. CMV Ig M came back positive. CMV IgG antibody +ve, CMV IgG avidity low. Consistent with recent primary CMV infection (less than 3 months ago). She is 35/40 today. Parvovirus not back yet. Liver autoantibody screen has com back negative. I want you to create a good comparison of LFTs in a table.
Created using ChatSlide
This case summary details a 35-year-old woman at 35 weeks of pregnancy with a history of miscarriage and normal booking bloods. Investigations reveal fluctuating liver function tests and normal blood pressure. A recent primary CMV infection is noted, alongside positive hepatitis A antibodies. Multidisciplinary management includes ongoing monitoring and specialist reviews. The delivery plan will consider maternal health risks and prematurity, ensuring a comprehensive approach to fetal...