Patient: Need to know how you would deliver news to pregnant patient, medical approach, and lots of patient education please.
Doctor: Hello,Thanks for the query.Pregnancy is suspected when one misses a regular period, has symptoms of nausea, v omiting and breast discomfort. These are non specific symptoms and can happen even without a pregnancy. We always confirm pregnancy by two things, a serum beta hcg which is a blood test. The doubling value of beta hcg for 48 hours interval is an evidence of an intra uterine pregnancy. This needs to be confirmed with an ultrasound examination. With this evidence, we can always inform and counsel the patient that she is pregnant and educate her about the ways to handle the pregnancy. It is upto her to decide if she would want to continue the pregnancy or not. Based on this, we further guide the mother. Hope this helps.Regards
Comments / Follow Ups
Patient: Yes, what I needed was what things would you specifically say to educate the patient on pregnancy, what would you offer for her perimenopausal symptoms, what about her divorce and impending pregnancy with her current alcohol and smoking, what would you say and offer her? I was looking for a much more thorough answer in regards to these things specifically. Thanks.
Any pregnancy after the age of forty is a risk for the mother as well as the baby. We would tell her about the outcomes of the pregnancy with her present lifestyle and medications she is on. Chances of neural tube defects, down’s syndrome and aneuploiodies has to be explained. The chances increase in the baby as the mothers age advances. Also we will have to explain about the risk of intra uterine growth restriction in the baby which could appear by 20 weeks of gestation. Maternal risks include pre eclampsia or high blood pressure, considering the age, diabetes, premature delivery, need for c sections, anemia due to alcohol intake and many more. We could explain all these as and when the pregnancy advances rather than creating a fear in her speculating the possibilities. In case she wishes to continue the pregnancy, she will be considered a high risk patient and will need more frequent ante natal visits and ultrasound.
Hope this hekos
Patient: Thank you, so is she able to get a medical abortion and/or surgical abortion? I’m confused because not sure if her last menstrual period was 3 months ago, medical abortion is indicated for when and medical abortion indicated for when?
Medical abortion is general done upto 63 days, and mostly successful Upto 49 days of pregnancy. After that there is a chance of failure and he can get converted to surgical.
Medical abortion can be done if there is no risks like previous scars in the abdomen due to surgeries, pregnancy within the suitable time of gestation and patient is medically fit. The reason could be contraception failure, I’ll health of mother any major physical or mental illness in mother and anomaly in the fetus