First, she is overage. The risks of complications in pregnancy increase with age. Mrs. K is already past the safe age of 35 years. Secondly, she is obese. This complicates further her pregnancy due to the risks of conditions such as hypertension. In fact, she has already developed gestational diabetes and has to depend on insulin. It is also worth noting that her social history does not adequately support her health needs. This is clearly demonstrated by her inability to afford insulin, glucometer and glucometer strips. Besides, she cannot effectively maintain adequate bed-rest prescribed.
Currently, the patient is out of hospital. She has been monitored for 37 weeks at what time her cerclage is released and delivery conducted. She delivers a six-pound, two-ounce baby spontaneously without many problems. The puerperium is normal with the mother and child discharged home after only 48 hours after delivery in good condition. The management has successfully controlled not only the risk of pregnancy but also helped retain the mothers’ hobby, knitting. This assists the mother to save money on the baby’s blanket and also keep her busy and away from junk foods.
The patient is diabetic and obese. She has to depend on insulin injections to control her blood sugars. She also has a bad obstetric history, having lost seven of her last pregnancies. She has only one surviving child, 18 years old.
She has had cramping and false signs of pregnancy which could be the cause of previous loss of pregnancy. For this, she requires close monitoring in a high-risk obstetric clinic to ensure that this pregnancy matures to term. During the early third trimester, the patient was diagnosed with urinary tract infection and placed on antibiotics in consultation with the physician.
This case was handled by qualified community obstetrician.