A 32-year-old female presents to the office seeking prenatal care. Her last normal menstrual period

Discussion in 'Step 3' started by Santosh Jadhav, Nov 25, 2013.

  1. Santosh Jadhav

    Santosh Jadhav Active Member

    A 32-year-old female presents to the office seeking prenatal care. Her last normal menstrual period began
    2 1/2 months before her visit. She believes that she is pregnant and has tested positive with a home pregnancy test. She has been pregnant twice before, with one living child and one spontaneous abortion (G3P1).
    She is married to the father of the children. She has no health problems but does smoke half a pack of cigarettes per day. She also admits to occasional alcohol use (1 drink every 2 weeks). She denies oral or intravenous drug use.
    Besides prenatal vitamins with iron, you recommend:
    A) Quitting smoking.
    B) Confirming the home pregnancy test with a serum HCG in your lab.
    C) HIV testing and counseling.
    D) A and C.
    E) All of the above.
  2. samuel

    samuel New Member

    The answer is D. Smoking during pregnancy
    is associated with lower birth weight and preeclampsia,
    and smoking in the house with a young child is
    associated with respiratory diseases, especially asthma.
    Although confirming pregnancy by examination
    (uterine size or fetal heart tones) and/or urine HCG is
    appropriate, serum HCG is unnecessary and expensive.
    Additionally, when used correctly, home pregnancy
    tests are highly sensitive and specific. HIV testing
    and counseling should be routinely offered to all
    women seeking prenatal care, regardless of their particular
    social situation. Routine testing for HIV in
    expectant females has dramatically reduced the HIV
    prevalence in children in developed countries. Vertical
    transmission of HIV is still a tremendous problem in
    Africa and other developing regions of the world.
    Remember that just testing for HIV antibodies is not
    enough—the patient must understand the purpose
    and implications of the test. Pre- and post-test counseling
    are always included with the blood draw.

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