The Cases of Mrs. A and Mrs. B

As we begin, we will all be working through the virtual case histories of Mrs. A and her baby and Mrs. B and her baby together. This case is a teaching case not just about two mother and babies but also about how this process may work.

(At the end of the first part, participants will experience...)

• Introduction to medical issues affecting 2 pregnant women, Mrs. A and Mrs. B

• A brief introduction to preparations for delivery of babies, and

• A discussion of what assessments (i.e., history items, laboratory tests, etc.) are required.

In the next cases, we will be assigning participants to teams.  Participants will begin to assume more and more of the facilitative role as they move through the questions and respond to each other. 

For now, let's begin by getting a sense of who these two families are as they deliver babies at University Hospital and prepare to leave the hospital for their homes in Northern New Mexico.  Please click on the link below and read about Mrs. A and Mrs. B You may want to print this out for later reference.  

Mrs. A: Mrs. A, a 22 year old pregnant woman, presents to the Testing and Triage area of the Labor and Delivery Unit of the University Hospital at the UNM Health Sciences Center on 29 October 2001. When she presents, the staff of Testing and Triage diagnose her as in active labor. When asked about her prenatal care, she states that she hasn’t gone to any clinics, but she hasn’t had any illnesses nor taken any medications. The nurses begin the usual admission procedures and order the usual laboratory tests anticipating delivery.

Mrs. B: Within the hour, a second woman presents the Testing and Triage area on 29 October 2001. When Mrs. B, a 22 year old pregnant woman, presents, the staff of Testing and Triage also diagnose her as in active labor. When asked about her prenatal care, she states that she went to a family planning clinic to confirm her pregnancy in February, but since then she hadn’t seen a medical provider. Mrs. B states that she hasn’t had any illnesses nor taken any medications. The nurses begin the usual admission procedures and order the usual laboratory tests anticipating delivery.

History obtained by the medical student admitting Mrs. A to Labor and Delivery:

When the medical student interviews Mrs. A, she tells her that she has had 5 pregnancies, delivered 2 children in the past who both live with her, and smoked marijuana daily until yesterday. She then starts with regular frequent contractions. The student and nurses move Mrs. A to the delivery room where she rapidly delivers a baby girl. The Apgar scores for the newborn are 7 at 1 minute and 9 at 5 minutes. The baby weighs 4 pounds and 9 ounces.

History obtained by the medical student admitting Mrs. B to Labor and Delivery:

A few hours after Mrs. A delivered her baby girl, the same medical student interviews Mrs. B. Mrs. B tells the student that she has had 5 pregnancies, delivered 2 children in the past who both live with her, but with the last baby she had "sugar diabetes." She then has a gush of amnionic fluid that starts regular frequent contractions. The student and nurses quickly move Mrs. B to the delivery room where she rapidly delivers her baby girl. The Apgar scores for the newborn are 7 at 1 minute and 9 at 5 minutes. The baby weighs 9 pounds and 9 ounces.

Questions regarding the assessments for the first part of the cases or what history do we want to obtain from these 2 mothers?

• What are the implications of the information obtained?

• How will we think about the information?