Page 128 - English For Nursing
P. 128
After reading the case, discuss with your group what the most appropriate treatment, the type of medication
and the type of childbirth are for this patient. You can take notes in the space provided below.
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Case 2
Marni is 31 years old and 35 weeks pregnant. She was initially seen in the emergency room of
the hospital in her community and was referred to a tertiary care centre in the city after being
assessed by the family doctor, who was concerned about preterm labour because of clear changes
in her cervix. Marni arrives at the tertiary centre escorted by a nurse who reports that she was
comfortable and had no contractions during the transfer. She reports that Marni has fever, urinary
symptoms, nausea, or vomiting and that her bowel movements have not been normal. Dr Green,
the on-call obstetrician, proceeds with a medical history. She has not had any terminations and
stillbirths but 2 miscarriages and has had 3 live births, all vaginal with 2 complicated labours. She
had gestational diabetes in her last 2 pregnancies and her antenatal visits for this pregnancy were
unremarkable apart from the diabetes, which is being well-controlled with insulin. On exam, the
fetus is in a frank breech presentation with the buttocks visible at the introitus. However, she
wants to give birth in the hospital in her community because being away from home, Marni is
concerned about her other children and is eager to get back home. She also does not want to have
caesarean section.
Adapted from https://www.jogc.com/article/S1701-2163(15)30710-6/pdf
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