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JubileeSkyBradley's Pregnancy
My Due Date: September 30, 2015I have given birth!
Age: 36 years old
Location: Azusa, United States
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Pre-conception continued...
By JubileeSkyBradley » Posted Sep. 24, 2015 1:12am - 327 views - 0 comments
4. “My cervical mucous was stretchy and slippery on day 6 & we went ahead and had intercourse. Do you think this will be ok?” How would you counsel the patient after this statement? (pg. 696t)
There are two methods that take cervical mucus into account in NFP.
-The cervical mucus method, also known as the ovulation or Billings method, in particular, determines fertility by assess the elasticity of the cervical mucus that is present. According to this method, intercourse should be avoided during menses as well as “from the time mucus appears until 4 days after clear, slippery, stretchy mucus ends” (Murray, 2014, p. 696).
Since Mrs. Bradley had intercourse during this timeframe when it should have been avoided, we must explain to her that stretchy and slippery cervical mucous indicates a time of high fertility and she may need to prepare for a possible pregnancy as a result. SH
Antepartum Part 1:
Mrs Bradley conceived on day 6 and is currently 8 weeks pregnant! After some disbelief, and shock, the couple have become excited about this new addition. They have subsequently cancelled their service with the Peace Corps.
You find the following in your patient history:
PMH: No hospitalizations. Denies significant medical history.
PSH: No surgical history.
FHX: Pt adopted at birth, does not know family history.
Social: Lives with husband in a monogamous relationship. One previous partner with unknown status related to STI’s. Occasional recreational marijuana use.
OB: G1P0
GYN: Herpes Simplex Virus (HSV) initial outbreak at age 20 with subsequent treatment with Acyclovir & no recurrent outbreak or lesions since initial diagnosis.
MEDS: No current medications or supplements.
Prepregnancy weight: 130 lbs, Ht: 5’4”
1. What is of concern related to the above history?
Of the history we find in the patient’s chart, we are concerned with a few findings. The patient was adopted and thus we have no family medical history. She uses marijuana occasionally and she is also a carrier of the Herpes Simplex virus. These three things must be brought up when talking with the patient. Her marijuana use must stop when pregnant and she will need counsel on measures that will be taken to prevent her baby from contracting HSV during childbirth.
2. Educate patient and spouse as to what development is occurring with the embryo?
At 8 weeks, the embryo is developing webbed fingers and toes. The eyelids almost cover the eyes and the nerve cells in the brain are continuing to branch out and connect with one another, forming neural pathways. The external genitals have not developed enough yet to reveal the gender. The baby is the size of a kidney bean and is constantly moving though the mother cannot feel this yet.
3. Pt reveals that she would like to continue to use recreational marijuana. Why is this not recommended for her?
Marijuana is strongly not recommended during pregnancy for various reasons.
Lower birth weight
Higher risk of complications, anomalies, and infant mortality
Marijuana increases blood carbon monoxide content and may reduce oxygen available to fetus
Neurobehavioral problems in infant: tremors and sleep disturbances
4. What labs/diagnostic tests are being offered or will be in the next month?
- During the first trimester of pregnancy, blood type and Rh factor are evaluated. There is also a screening for anemia, immunity to rubella, a test for Hep B, syphilis, HIV, and other STDs.
-Urine tests are done to identify signs of kidney infection, measure the levels of hCG (to confirm pregnancy), gestational diabetes, and albumin (a protein that can indicate preeclampsia/pregnancy-induced HTN).
My Journal
Pre-conception continued...
By JubileeSkyBradley » Posted Sep. 24, 2015 1:12am - 327 views - 0 comments
4. “My cervical mucous was stretchy and slippery on day 6 & we went ahead and had intercourse. Do you think this will be ok?” How would you counsel the patient after this statement? (pg. 696t)
There are two methods that take cervical mucus into account in NFP.
-The cervical mucus method, also known as the ovulation or Billings method, in particular, determines fertility by assess the elasticity of the cervical mucus that is present. According to this method, intercourse should be avoided during menses as well as “from the time mucus appears until 4 days after clear, slippery, stretchy mucus ends” (Murray, 2014, p. 696).
Since Mrs. Bradley had intercourse during this timeframe when it should have been avoided, we must explain to her that stretchy and slippery cervical mucous indicates a time of high fertility and she may need to prepare for a possible pregnancy as a result. SH
Antepartum Part 1:
Mrs Bradley conceived on day 6 and is currently 8 weeks pregnant! After some disbelief, and shock, the couple have become excited about this new addition. They have subsequently cancelled their service with the Peace Corps.
You find the following in your patient history:
PMH: No hospitalizations. Denies significant medical history.
PSH: No surgical history.
FHX: Pt adopted at birth, does not know family history.
Social: Lives with husband in a monogamous relationship. One previous partner with unknown status related to STI’s. Occasional recreational marijuana use.
OB: G1P0
GYN: Herpes Simplex Virus (HSV) initial outbreak at age 20 with subsequent treatment with Acyclovir & no recurrent outbreak or lesions since initial diagnosis.
MEDS: No current medications or supplements.
Prepregnancy weight: 130 lbs, Ht: 5’4”
1. What is of concern related to the above history?
Of the history we find in the patient’s chart, we are concerned with a few findings. The patient was adopted and thus we have no family medical history. She uses marijuana occasionally and she is also a carrier of the Herpes Simplex virus. These three things must be brought up when talking with the patient. Her marijuana use must stop when pregnant and she will need counsel on measures that will be taken to prevent her baby from contracting HSV during childbirth.
2. Educate patient and spouse as to what development is occurring with the embryo?
At 8 weeks, the embryo is developing webbed fingers and toes. The eyelids almost cover the eyes and the nerve cells in the brain are continuing to branch out and connect with one another, forming neural pathways. The external genitals have not developed enough yet to reveal the gender. The baby is the size of a kidney bean and is constantly moving though the mother cannot feel this yet.
3. Pt reveals that she would like to continue to use recreational marijuana. Why is this not recommended for her?
Marijuana is strongly not recommended during pregnancy for various reasons.
Lower birth weight
Higher risk of complications, anomalies, and infant mortality
Marijuana increases blood carbon monoxide content and may reduce oxygen available to fetus
Neurobehavioral problems in infant: tremors and sleep disturbances
4. What labs/diagnostic tests are being offered or will be in the next month?
- During the first trimester of pregnancy, blood type and Rh factor are evaluated. There is also a screening for anemia, immunity to rubella, a test for Hep B, syphilis, HIV, and other STDs.
-Urine tests are done to identify signs of kidney infection, measure the levels of hCG (to confirm pregnancy), gestational diabetes, and albumin (a protein that can indicate preeclampsia/pregnancy-induced HTN).
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