A 27-Year-Old Primigravida at 18 Weeks Gestation Comes to the Office

A 27-year-old primigravida at 18 weeks gestation comes to the office for a routine prenatal visit and an anatomy ultrasound.  The patient feels well and has no concerns.  She is accompanied by her mother as her husband was unable to get off work.  The patient has no chronic medical conditions, and her only daily medication is a prenatal vitamin.  Ultrasound shows a cephalic singleton fetus measuring at <10th percentile consistent with severe growth restriction.  There are bilateral choroid plexus cysts, clenched fists, and a large ventricular septal defect.  Amniotic fluid level is normal.  The placenta is posterior and fundal.  Which of the following is the most appropriate initial statement by the physician?

A) "Could I speak to you in private about my concerns with your ultrasound findings?"
B) "I'm sorry to tell you this, but it appears that the ultrasound findings are suggestive of a genetic anomaly."
C) "Let's schedule a follow-up visit to discuss the results when your husband can be here with you."
D) "There are some things about your ultrasound that I need to discuss with you; is it okay to do that now?"
E) "Would it be okay if your mother stepped out of the room so we can talk about your results?"