SCA practice case · Telephone consultation
Women’s health: SCA practice case
A pregnant woman calls about her baby
Telephone consultation
Adult patient
Typical
Urgent & unscheduled careGender, reproductive & sexual healthHealth disadvantage & vulnerabilities
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Chantelle Okafor-Reid · 29-year-old woman
Setting
Telephone consultation with a woman who is 30 weeks pregnant and has asked for a call back about her baby.
Past history
- Pregnant: 30 weeks + 2 days (gravida 4, para 3); three previous vaginal births at term
- Booking BMI 33
- Smoker, about 8 cigarettes a day
Medication
- Aspirin 150 mg at night (from 12 weeks, pre-eclampsia risk)
- Pregnancy multivitamin with folic acid and vitamin D
Allergies
No known drug allergies
Recent notes
Maternity triage 12 days ago (28+4 weeks) for reduced fetal movements: CTG normal, BP 118/72, discharged. Growth scan at 28 weeks: estimated fetal weight 40th centile, normal liquor. Midwife note: partner works away during the week; no car; three children aged 9, 6 and 3.
Reason for contact
Asked for a GP call back “about the baby”. Told reception: “Not urgent, whenever the doctor’s free.”
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
Reduced fetal movements after 28 weeks need same-day assessment with CTG on the maternity unit; reassurance by telephone, counting kicks, waiting or relying on a home Doppler are all unsafe. Recurrent episodes increase concern. This station is about acting on a time-critical symptom while removing every barrier that would stop her going: fear of wasting time, no transport, no money, a toddler at home and children to collect from school. The hidden fear of stillbirth explains why she minimised.
The guidance behind it
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