An 18-year-old G2P1L1 with a last menstrual period of May 7 presents for her first OB visit at 10 weeks. The patient had a previous pregnancy complicated by gestational diabetes and delivered a 4.2kg baby boy cesarean section after a long labor. All of the following should be performed at each prenatal visit except
**Core Concept**
Prenatal care involves regular assessments and interventions to ensure the health and well-being of both the mother and the fetus throughout pregnancy. These visits are crucial for monitoring fetal growth, detecting potential complications, and making informed decisions about the pregnancy.
**Why the Correct Answer is Right**
At each prenatal visit, the healthcare provider should perform a thorough physical examination, including blood pressure measurement, to monitor for potential complications such as preeclampsia. Additionally, the provider should assess the patient's weight and height to calculate her body mass index (BMI), which can help identify potential risks associated with gestational diabetes and obesity. Furthermore, the provider should perform a urinalysis to check for proteinuria, which can indicate preeclampsia or other kidney problems.
**Why Each Wrong Option is Incorrect**
**Option A:** Blood glucose monitoring is a crucial aspect of prenatal care, especially for patients with a history of gestational diabetes. This should be performed at each prenatal visit to monitor the patient's blood sugar levels and adjust treatment as needed.
**Option B:** A detailed fetal anatomy scan is typically performed between 16 and 20 weeks of gestation to assess the fetus's growth and detect any potential anomalies. While this is an essential part of prenatal care, it is not performed at each prenatal visit.
**Option C:** A complete blood count (CBC) is often performed during pregnancy to monitor for potential complications such as anemia or infections. However, this is not necessarily performed at each prenatal visit, and the frequency of CBCs may vary depending on the patient's individual needs and risk factors.
**Option D:** A group B streptococcus (GBS) screening is typically performed between 36 and 37 weeks of gestation to assess the patient's risk of transmitting GBS to the baby during delivery. While this is an important aspect of prenatal care, it is not performed at each prenatal visit.
**Clinical Pearl / High-Yield Fact**
The American College of Obstetricians and Gynecologists (ACOG) recommends that patients with a history of gestational diabetes be screened for diabetes and other metabolic disorders at each prenatal visit.
**Correct Answer:** B.