prenatal case study development

prenatal case study development

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prenatal case study development

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First, complete the following activities in MindTap:

• Explore: Chapter 2 Investigate Development Prenatal
• Decide: Chapter 2 Investigate Development: Prenatal
• Think about the factors that influenced your recommendations for Catarina. Why did you choose the option(s) that you did? Address the questions associated with twoof the following four issues in your response:
• What are critical periods in the development process of an embryo and fetus? When do they occur and how might they be disrupted?
• Which aspects of diet and exercise do you think are most critical during pregnancy?
• What are the effects of alcohol, cigarette smoke, or e-cig vapors on a developing fetus?
• What are the risks and benefits of Catarina remaining on antidepressants during her pregnancy, both for Catarina and for her baby?

Remember, you only need to select two of the issues to address in your discussion posting.

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(My response so far): My recommendation for Catarina A. Catarina should maintain a healthy diet and appropriate exercise regimen and avoid unnecessary exposure to environmental contaminants. She should also continue taking her current antidepressants. Many factors played into why I decided to choose this option….

Examples of different responses:

For Catarina the decision I chose based on the research given was option A. Catarina should maintain a healthy diet and appropriate exercise regimen and avoid unnecessary exposure to environmental contaminants. She should also keep taking her current antidepressants. I chose this option for many reasons.

The most important factor for my decision was the letter from her psychiatrist. Knowing that she has tried multiple times to lessen her dose of antidepressants without any success made me believe that it was in her best interest to stay on the medication.

The risk to her mental health, that has proven to be inevitable when she stopped or decreased her medication outweighed the potential risks that the child may experience after birth. Although Catarina has expressed that she is not on a diet and does not exercise both are very important for the wellbeing of both the mother and the child.

Pregnant women who are overweight are at risk for multiple risks like gestational diabetes, preeclampsia, urinary tract and postpartum infections, overdue pregnancy, complications of labor and delivery, and pregnancy loss (Kail & Cavanaugh, 2017).

Due to this fact having Catarina practicing healthy eating and moderate exercise will keep her weight healthy, which in turn keeps her and the baby healthy. This will reduce her risks of complications during her pregnancy.

Catarina also expressed her concerns about alcohol use and e-cig vapor during pregnancy as well. Luckily Catarina stopped drinking alcohol when she found out she was pregnant. Prolonged use of alcohol and smoking of any kind can cause physical and psychosocial problems for the fetus, including miscarriage, stillbirth, low birth weight, prematurity, physical malformations, and neurological damage (Kail & Cavanaugh, 2017).

With her choice to stop drinking and to stay away from all forms of smoke, Catarina’s baby should remain healthy and her pregnancy should continue smoothly without major complications.

Her concerns are valid and with the decision to maintain a healthy diet, exercise, stay on her medication, and to avoid unnecessary exposure to environmental contaminants, she should have no problem giving birth to a happy and healthy baby.

Catarina’s case is one that happens more often than not. People get pregnant without planning and are usually not aware of the consequences their lifestyle will have on the child. I chose option B where Catarina needs to address her lifestyle (diet, exercise, environment) but should attempt to see if there might be another possible solution to her depression.

Having a healthiest pregnancy should be the goal for everyone. Part of that is maintaining a healthy eating habit and staying physically fit. To achieve the best possible outcome for the mother and the baby Catarina needs to have a discussion with the gynecologist on what her needs are and how to achieve the best outcome for the baby.

Listening to Catarina talk I get the sense that she is aware of the lifestyle that she was living and the changes that she should make. From the first week to the fortieth it is important for Catarina to take care of herself so she can take care of the baby. What happened in the past is the past, its never to late to make choices for the better.

Those choices include prenatal vitamins, well balanced diet and plenty of fluids. Its important to keep in mind that nutritional choices that a woman makes will contribute directly to the health and the development of the baby (Ben-Joseph, 2018). Exercise is a big plus, it helps a woman feel better, look better but it helps prepare the body for birth.

Additional benefits are that it can lower the risk of complications like preeclampsia and gestational diabetes (Reynolds, 2019).To keep taking the antidepressants is a difficult decision for any mother. Knowing their possible side effects its not easy to make a decision that can have long lasting effects on the mother and the baby.

According to her psychiatrist report Catarina has attempted to reduce or change her medication without success. According to the Mayo Clinic (2019) mothers who use antidepressants during pregnancy have a low risk of birth defects but some of them are associated with a higher risk of complications.

It’s important for Catarina to talk to a healthcare provider to make sure the choice to continue using or changing the medication gives her and the baby the best chance for long term health. In Catarina’s case its important to make sure that her health is optimal because unstable depression can only increase risks for her and the baby.

My recommendation for Catarina was to address the issues of a healthy diet and environment as well as exercise, but her physician should also explore whether to change to another dose or type of antidepressant. I came to this conclusion when considering the stage of Catarina’s pregnancy and her past use, along with her current use, of the antidepressant.

Catarina is still in a very crucial stage of fetal development in her pregnancy and still has a long way to go. Sacks (2015) supported the fact that from 3-8 weeks gestation, the fetus’ developmental risks from alcohol, certain medications, infections, and other teratogens are highest.

Furthermore, Mother To Baby (2015) showed that the risks to the developing central nervous system start at 3 weeks but then continue through week 20. These findings suggest that the first four months of pregnancy are extremely crucial for the normal development of the baby.

Additionally, brain development continues through the third trimester, and any effects from teratogens may not be recognized until later in life (Behnke & Smith, 2013). However, there may be a chance that damage has not been done if the mother and physician address these risk factors early.

Since Catarina is around 6 weeks pregnant, then she has the ability to make the changes necessary to ensure a healthy and successful remainder of her pregnancy. She stated that once she had a positive pregnancy test she quit drinking alcohol, however, she has had to stay on her antidepressant due to past relapse experiences when trying to wean off of it.

My suggestion is for the physician to reconsider the type of medication she is taking and the dosage, to ensure that she is on one that poses the least risk to the developing fetus. Hopefully, since she has been of child-bearing age since she started taking the medication, these factors had already been considered.

However, with the expanding knowledge and release of new and improved medications constantly being introduced into the market, there may be one that may be a better choice for Catarina. I do not recommend for her to stop taking the medication as that may pose some long term effects to Catarina, but she does need to be made aware of the possible risks they can cause to the baby (Hanley & Oberlander, 2014; Byatt et al., 2013).

My advice to Catarina was to address issues with her diet and exercise as well we her environment, and she should explore different depression medications that could be safer with her doctor.

During the embryonic stage up to 8 weeks after fertilization is crucial, it’s when major systems and organs begin development, the most critical period for the central nervous system is the longest during the pregnancy with greater risks up to 20 weeks (Kail & Cavanaugh, 2019).

Catalina reported only drinking socially about 4-5 drinks per week, and since she found out about her pregnancy at 6 weeks she’s stopped any alcohol consumption. Also, brain development continues into the second and third trimester, however the effects of the teratogens on long term behavior may not be noticed until later in life (Kail & Cavanaugh, 2019).

Although Catalina’s anti-depressants may be harmful to the fetus, the consequences for her depression on the fetus would be much more of a concern, meaning she can’t just come off the medication without causing risk for the fetus as her doctor reported they had tried to lower her dose from 40 mg and each time she experienced depressive symptoms.

Maternal depression during pregnancy is associated with poor mother-infant bonding, mothers who experience depression are also at risk for other health conditions like preeclampsia and low birth weight (Kail & Cavanaugh, 2019). She should be fully aware of the risks to staying on the medication versus changing or stopping, in this case she should abstain from alcohol use especially while taking medications, increase her activity level and introduce better foods with higher amounts of folic acid into her diet, and Since she has a good support system, and is financially stable.

She should be concerned about the risks of secondhand smoke and should encourage her spouse to quit. My recommendation for Catarina was option A: Catarina should maintain a healthy diet and appropriate exercise regimen and avoid unnecessary exposure to environmental contaminants. She should also keep taking her current antidepressants.

What are the risks and benefits of Catarina remaining on antidepressants during her pregnancy, both for Catarina and for her baby?

Catarina has attempted in the past to reduce her anti-depressant use with the goal of discontinuing use entirely. Both of her attempts were overseen by psychiatrist and both attempts were unsuccessful and caused major depressive issues to resurge.

Considering there are minor complications associated with use of SSRIs during pregnancy (small reduction in gestational age, potential autism spectrum link, and postnatal adaptation syndrome) and major complications associated with maternal depression and stress (low birth weight, prematurity, stunted growth, slowed brain development, cognitive deficiencies, behavioral problems, cardiovascular health, and poor mother-infant bonding).

I believe it is in Catarina and her baby’s best interest to continue her antidepressant use throughout her pregnancy. Which aspects of diet and exercise do you think are most critical during pregnancy?

Catarina has confided that she is slightly overweight and does not exercise. She also does not consume a well-balanced diet. It is very important for Catarina’s health and the health of her baby that she adjusts her diet and exercise routine.

It is very important at this early stage of Catarina’s pregnancy that she significantly slow or completely halt her caffeine intake as caffeine can cause miscarriage or low birth weight. It is also very important that Catarina start a moderate, pregnancy safe exercise routine.

Being overweight, Catarina is at a heightened risk for gestational diabetes, preeclampsia, pregnancy loss, etc. Engaging in a healthy diet with low amounts of fat, sodium, and processed sugars and high amounts of folic acid, protein, and iron will help Catarina to maintain a healthier weight and lower risk pregnancy.

prenatal case study development

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