I am pretty much halfway through my obstetrics and gynecology rotation. I am loving it! I especially like clinic. I love talking to women about pregnancy, birth, reproduction, their bodies, and sex. I can’t believe I still have to do rotations in other specialties. I want to do only ob/gyn from now on.
Even though I am loving it, sometimes it’s still really frustrating. There was a patient who came in for an initial prenatal visit who had a shocking obstetrics history – several miscarriages, many more than the three required to be considered a “habitual aborter”, and one live birth. She is in her second trimester now.
What was even more frustrating to me is that she seemed to have no clue about her past work ups or treatment during this pregnancy. She has been treated by another practice, including a perinatologist whose name she couldn’t quite remember. She doesn’t know if she has been given any medicine to help her carry this pregnancy. She doesn’t know the names of the medicines she was given when she was hospitalized during her only successful pregnancy. Oh, and she had an unexplained heart attack last year that got her admitted to the hospital. She seemed most concerned with whether the doctor could give her a tummy tuck with her cesarean, and was proud that she had been so sick this pregnancy that she hadn’t gained any weight.
I strongly suspected, with that history, that she may be abusing cocaine. I treated her with respect, and tried to glean as much information from her as I could. I did ask her if she used cocaine, and explained it is linked to heart attacks in young adults and pregnancy losses. She denied it. Or, she could have a clotting disorder, or one of many other issues. I asked her if she had ever had a work up to see why she had such trouble maintaining a pregnancy, especially to see if she had a clotting disorder. A factor V Leiden disorder could cause repeated losses and heart attack. She wasn’t sure.
Speaking of which, according to my blog dashboard, someone found my blog by using this search string:
“does a fetus withdrawl in the whom”