Pregnancy and Reproductive Health 2

A 36-year-old woman, gravida 3 para 2, at 20 weeks gestation attends the prenatal clinic to review her routine second-trimester ultrasound. She has had no vaginal bleeding, pain, or leakage of fluid, and both previous pregnancies ended in uncomplicated vaginal deliveries. She takes a prenatal multivitamin and has no known drug allergies. Her blood group is A Rh-negative with a negative antibody screen. The ultrasound report describes a single live fetus with cardiac activity, normal anatomy, and growth consistent with dates; the placenta is posterior and completely covers the internal cervical os.