A 34 years G4P1+2 female at 30 weeks gestation complaints lethargy. On examination uterus is 28 weeks size. FM positive and Fhs 160/min. Medical history- Ankylosing spondylosis and on sulfasalazine 500 bd . Surgical history- Cholecystectomy 4 years back. Obstetric history- first child LSCS 10 years back. 2 MTP due to foetal non-development 4 and 2 years back.
Gynaecological history torch positive IGM CMV USG report reveals giant cisterna magna 15 mm and IUGR. Weight- 1560gms weeks 30 EDD- 25 Nov 15, no congenital abnormalities noted, all routine blood, urine, stool reports are normal except RBS 140 which can be accepted. Patient party denies any invasive procedure such as Amniocentesis or Cordocentesis. They are uneducated and poor. Should I advise them an MRI or MTP. Please advice as medical infrastructure is very poor here.
