OB Case:
I had a 34-year old African American woman presented to the OB clinic for her post partum/new OB appt. The patient was a 6-week post-partum visit from a D & C she received during her 4th month of pregnancy as a result of a massive fibroid. At that time the patient was informed and scheduled for surgery to have the fibroid removed. The patient resumed intercourse in hopes of having a baby in which she became pregnant again. The problem/issue is that this patient needs to have the fibroid removed prior to being able to maintain this pregnancy. The patient was counseled on the seriousness of this massive fibroid and the implications of future pregnancies and yet the patient is now pregnant again. The patient, in denial does not fully understand nor does she show any interest in what the effects of this fibroid can do to her and her upcoming pregnancy. She does not want to face reality even when shown with Ultrasound the size of the fibroid. I am personally amazed that she even became pregnant again. I know that sometimes women with fibroids have a hard time getting pregnant and yet she managed to get pregnant before her 6-week post-partum visit. I am just astonished by it. Education was enforced along with signs and symptoms as well as the risks explained to the patient. The patient was also informed of the possibility of a Myomectomy (although rare) to be performed during her pregnancy and she was referred to Maternal Fetal Health for High Risk Pregnancy.
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Sheila, it seems the desire to be pregnant all to often supercedes the ability to make rational and fair decisions. Just as your woman was not willing to wait until the fibroid was removed I had a 40 y/o woman present for new OB that was diagnosed with Hepatitis C 5 years ago. She contracted the Hepatitis C through illegal intravenous drug use. She looked 60 years old. She has chronic Hepatitis C and the transmission rate to the fetus depends on the mothers viral load. The CDC reports about 4 of every 100 infants born to mothers with Hepatitis C become infected with the virus. It upsets me anyone would run the risk of transmission. She is currently asymptomatic but referred to MFM for management.
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