CASE STUDY: Active Labor: Susan Wong

Priority Data to Collect

• History: Mrs. Wong is a first-time mother, 38 weeks pregnant with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but she never followed through. She and her husband disagreed about what to do if the ultrasonography indicated a spinal problem, so they felt they did not want this information.
• Current Presentation: Mrs. Wong is in early labor after spontaneous rupture of membranes (SROM). She is at 38 weeks of gestation, and she is likely experiencing anxiety and uncertainty due to her history of abnormal alpha-fetoprotein levels and her disagreement with her husband about the possibility of terminating or continuing the pregnancy.

Interventions to Meet the Couple's Needs

• Provide emotional support and counseling: The nurse can provide emotional support to both Mrs. Wong and her husband by listening to their concerns, answering their questions, and helping them to explore their options. The nurse can also refer the couple to a counselor for additional support.
• Respect the couple's autonomy: The nurse should respect the couple's decision not to have an ultrasonography to rule out open spinal defects or Down syndrome. However, the nurse should continue to provide education and counseling about the risks and benefits of prenatal testing and the options available to them if the baby is born with a disability.
• Prepare for a possible negative outcome: The nurse should be prepared for the possibility of a negative outcome, such as a baby with an open spinal defect. The nurse can do this by developing a plan of care that includes both medical and emotional interventions. The nurse should also be familiar with the resources available to families with children with disabilities.

Personal Views on Terminating or Continuing a Pregnancy with a Risk of a Potential Anomaly My personal views on terminating or continuing a pregnancy with a risk of a potential anomaly are complex and nuanced. I believe that every woman has the right to make her own decision about her body and her pregnancy. However, I also believe that it is important for women to have access to accurate information about the risks and benefits of all of their options, including the option of continuing the pregnancy and raising a child with a disability. Factors that may influence my views include:

• The severity of the potential anomaly
• The quality of life that the child is likely to have
• The woman's personal beliefs and values
• The support system that the woman has available to her

How Maternity Care Will Change in the Future with the Influence of the Human Genome Project The Human Genome Project has revolutionized our understanding of human genetics. With the ability to sequence the entire human genome, we are now able to identify genetic mutations that are associated with a variety of diseases and conditions, including open spinal defects. This new knowledge is likely to have a significant impact on maternity care in the future. For example, it may be possible to develop new screening tests that can identify fetuses at risk for open spinal defects earlier in pregnancy. This would give women more time to make informed decisions about their pregnancies. In addition, the Human Genome Project is leading to the development of new treatments for genetic disorders. For example, researchers are developing gene therapies that could potentially correct the genetic mutations that cause open spinal defects. These advances in genetic testing and treatment have the potential to improve the outcomes for women and babies with open spinal defects. However, it is important to note that these technologies are still in their early stages of development, and it is important to weigh the risks and benefits carefully before making any decisions. Conclusion Maternity care is changing rapidly due to the influence of the Human Genome Project. New genetic tests and treatments have the potential to improve the outcomes for women and babies with open spinal defects. However, it is important to weigh the risks and benefits carefully before making any decisions. As a nurse, it is important to provide emotional support and counseling to couples who are facing the possibility of a pregnancy with a potential anomaly. It is also important to respect the couple's autonomy and to provide them with accurate information about all of their options.  

Sample Solution