ID #: 8496196 ALEXANDRA C MORILLO FERNANDEZ OBSTETRICS REPORT 4 of 4 visit(s) Date: 04/11/2024

Charlotte
905 Kenilworth Ave Phone: 704-468-0300
Unit A Fax: 704-355-5891
Charlotte, NC 28204

Maternal Fetal Medicine-Charlotte

OBSTETRICS REPORT Signed Final 04/11/2024 04:00 pm

Patient Info
ID #: 8496196 Name: ALEXANDRA C MORILLO D.O.B.: 12/06/88 (35 yrs)(F) Date: 04/11/2024 03:33 pm
FERNANDEZ

Performed By
Performed By: Debbie N Garner RDMS Referred By: ClinicMP Myers Park OB/Gyn-CMC
Attending: Michael Smrtka, MD Ref Address: CMC-Myers Park OB/Gyn
Exam Location: AH-Kenilworth 1350 South Kings Dr.
Charlotte, NC 28207

Orders
Description Code Ordered By Order # Accession # Episode #
ASOB ULTRASOUND (MFM US100 MICHAEL 725852320 900US242322556 6709179066
USE ONLY) SMRTKA

Service(s) Provided
Code
US OB Follow Up 76816 76816-26 / 49002

Indications
Code
31 weeks gestation of pregnancy Z3A.31
Supervision of other high risk pregnancies, second trimester O09.892
Other specified disorders of amniotic fluid and membranes, second trimester, not
O41.8X20
applicable or unspecified
Other antepartum hemorrhage, second trimester O46.8X2
Supervision of elderly multigravida, second trimester O09.522
Bariatric surgery status complicating pregnancy, second trimester O99.842
Maternal care for unspecified type scar from previous cesarean delivery O34.219

Info
Allergic To Latex: No Pain: 0

Comment: Learning needs assessed: A language barrier was identified as a learning need at this time. An
interpreter was used to facilitate discussion. Patient prefers to learn by discussion.

Fetal Evaluation
Number Of Fetuses: 1 Presentation: Cephalic
Fetal Heart Rate(bpm): 142 Placenta: Anterior
Cardiac Activity: Observed
Amniotic Fluid
Amniotic F.V.: Normal
RUQ: 3.08 cm RLQ: 5.65 cm LUQ: 5.04 cm LLQ: 4.14 cm
AFI Sum: 17.91 cm 67 %Tile: Largest Pocket: 5.65 cm

Comment: Low suspicion for accreta

Electronically Signed Final Report by Michael Smrtka, MD 04/11/2024 04:00 pm

© Copyright 1991 - 2024 AS Software Inc. All Rights Reserved. www.as-software.com Ver 9.34 Page 1 of 4
ID #: 8496196 ALEXANDRA C MORILLO FERNANDEZ OBSTETRICS REPORT 4 of 4 visit(s) Date: 04/11/2024

Biophysical Evaluation
Amniotic F.V: Pocket => 2 cm two planes F. Tone: Observed
F. Movement: Observed Score: 8/8
F. Breathing: Observed

Biometry
BPD: 79.6 mm G. Age: 32w 0d 69 %tile CI (BPD/OFD): 75.8 %
OFD: 105 mm FL/HC: 20.2 %
HC: 294.1 mm G. Age: 32w 3d 55 %tile HC/AC: 1.02
AC: 287.1 mm G. Age: 32w 5d 90 %tile FL/BPD: 74.7 % 71 - 87
FL: 59.5 mm G. Age: 31w 0d 36 %tile FL/AC: 20.7 %
LV: 7.39 mm
Estimated FW: 1907 gm. 4 lb 3 oz 62 %Tile

OB History
Gravidity: 2 Term: 1 Prem: SAB: TOP: Ectopic: Living: 1

Gestational Age
LMP: 35w 0d Date: 08/10/23 EDD: 05/16/24
U/S Today: 32w 0d EDD: 06/06/24
Best: 31w 0d Determined By: Early Ultrasound (11/02/23) EDD: 06/13/24

Anatomy
Cavum: Appears Normal Stomach: Appears Normal
Ventricles: Appears Normal Kidneys: Appears Normal
Heart: Limited but previously seen Bladder: Appears Normal

Diagnosis
Description Code Comments
Supervision of other high risk pregnancy,
O09.892
unspecified, second trimester
AMA>1 second trimester O09.522
Previous cesarean delivery O34.219
Unspecified maternal hypertension, second
O16.2
trimester
Bariatric surgery status complicating
O99.842
pregnancy,second trimester
31 weeks gestation of pregnancy Z3A.31

Impression
I have personally reviewed the ultrasound images.

IUP measuring at 32w 0d by ultrasound today.

Best gestational age available is 31w 0d as determined by Early Ultrasound (11/02/23).
Clinical correlation is necessary to confirm Best GA due to limited clinical data available to sonologist.

EFW is 1907 grams at 62%

Presentation is Cephalic
Amniotic fluid is Normal 17.91
Placenta is Anterior
Incidental BPP of 8/8.

Please see separate letter in EPIC. Both the letter and the US report can now be found on the EPIC imaging tab.

Recommendations
Follow up ultrasound scheduled in 4-5 weeks to re evaluate fetal growth.

Electronically Signed Final Report by Michael Smrtka, MD 04/11/2024 04:00 pm

© Copyright 1991 - 2024 AS Software Inc. All Rights Reserved. www.as-software.com Ver 9.34 Page 2 of 4
ID #: 8496196 ALEXANDRA C MORILLO FERNANDEZ OBSTETRICS REPORT 4 of 4 visit(s) Date: 04/11/2024

Thank you for involving us in the care of this patient. Please do not hesitate to contact us if you have any questions or concerns.
Michael Smrtka, MD
Electronically Signed Final Report 04/11/2024 04:00 pm
ID #: 8496196 ALEXANDRA C MORILLO FERNANDEZ OBSTETRICS REPORT 4 of 4 visit(s) Date: 04/11/2024
AC Hadlock et al, 1984 HC Hadlock et al, 1984
40 cm. 40 cm.
< 97 %
< 97 %
35 < 50 %
35 < 50 %
< 3% < 3%
30 30
25
25
20
20
15
15
10
10
5
wks wks
5
12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40

FL Hadlock et al, 1984

HCACG Graph table was deactivated
9 cm.
< 97 %
8 < 50 %
< 3%
7
6
5
4
3
2
1
wks
0
12 14 16 18 20 22 24 26 28 30 32 34 36 38 40

Fetal Weight Williams et al, 1982

4500 gm

4250
< 90 %
4000

3750
3500
< 50 %
3250
3000
2750 < 10 %

2500

2250
2000

1750
1500

1250
1000
750
500
250
wks
0
22 24 26 28 30 32 34 36 38 40 42 44 46 48

Electronically Signed Final Report by Michael Smrtka, MD 04/11/2024 04:00 pm

© Copyright 1991 - 2024 AS Software Inc. All Rights Reserved. www.as-software.com Ver 9.34 Page 4 of 4