Demetrius L. Woods, II, MD, MPH


October 23, 2012

Clinical Presentation: "Did I Mention the Pain in My Leg?"

A 38-year-old G3P1AB1LC1 woman at a gestational age of 34 weeks and 3 days presents to your office for a routine prenatal care visit. Her prenatal course has been complicated by obesity, with a body mass index of 41 kg/m2 before pregnancy and a subsequent weight gain of 40 lb.

The patient reports good fetal movement and no signs or symptoms of preterm labor. Her glucose screening was normal. Before leaving, the patient reports pain in her left leg that has been worsening since returning from a family vacation 2 days ago.

The following are noted on physical examination:

  • Vital signs: heart rate, 99 beats/min; respiratory rate, 18 breaths/min; blood pressure, 136/86 mm Hg; temperature, 36.8°C;

  • Oxygen saturation: 100% on room air;

  • Morbidly obese;

  • Swollen, tender left lower extremity, with no palpable cords; and

  • Lungs: clear to auscultation.