Carol and Dave are new clients at your obstetrics office. They are both 27 years old. You are asking them about the reason for their visit. Carol says she thinks she is pregnant because she missed a period, again. Her last normal menstrual period was 04/03/2020. Dave tells you Carol is always nauseated in the morning. They have not been using birth control and have wanted to have children since they got married last summer. Carol says her clothes are feeling tighter and her breasts seem tender, but that happens every month with her cycle. Dave says he has noticed that Carol has been frequently getting up to go to the bathroom at night. Carol is concerned because she has a half-sister who has Down syndrome, had one miscarriage at age 25 and she had one elective abortion when she was 17 years old.
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