New Pregnancy Consultation - Clinical Skills - Dr Gill

Summary

In this video, Dr. Bethany Gill conducts a first pregnancy consultation with Bethany, discussing key aspects of prenatal care. The consultation covers topics such as the patient's supplements, medical history, mental health, medications, and vaccination status. Dr. Gill emphasizes the importance of monitoring blood pressure, avoiding certain medications like ibuprofen, and ensuring proper support at work. The session also touches on lifestyle factors, like alcohol and drug use. As a medical professional herself, Bethany shares insights on managing a pregnancy while maintaining a busy career. The video provides a useful overview for those interested in pregnancy assessments.

Takeaways

• 😀 The consultation begins with Dr. Gill confirming the patient's identity (Bethany Gill, DOB 10th August) and establishing rapport.
• 😀 The patient is confirmed to be pregnant, around 7–8 weeks, and is excited but also feeling some nervousness.
• 😀 Dr. Gill discusses the patient’s menstrual history (last period on March 20th) and the regularity of her periods.
• 😀 The patient is currently taking folic acid (400 mcg) and vitamin D (800 IU), both of which are essential for pregnancy care.
• 😀 The patient's medication regimen includes Citalopram (20 mg) for anxiety and Fexofenadine (120 mg) for seasonal allergies, both of which are considered safe in pregnancy.
• 😀 Dr. Gill advises continuing the Citalopram medication due to its importance for maternal mental health, despite the uncertainty about its safety during pregnancy.
• 😀 Allergies discussed: pollen and prawns; no known drug allergies.
• 😀 Dr. Gill checks the patient’s vaccination history, confirming flu and COVID vaccines were up to date, and tetanus requires a booster later in pregnancy.
• 😀 The doctor informs the patient about medications to avoid during pregnancy, especially ibuprofen, and encourages using paracetamol for any aches or pains.
• 😀 Dr. Gill explains the importance of staying hydrated and monitors the patient’s blood pressure (100/60 mmHg) as it may drop slightly during pregnancy.
• 😀 The patient’s height and weight are checked to calculate her BMI, and a urine sample is requested to test for asymptomatic bacteriuria, which can affect pregnancy.
• 😀 Dr. Gill advises that the patient book an appointment with a midwife for continued care, scans, and follow-ups throughout the pregnancy.
• 😀 The consultation concludes with Dr. Gill humorously referring to the pregnancy as a shared experience, reinforcing support for the patient.

Q & A

What is the primary focus of the consultation in this transcript?

The primary focus of the consultation is to assess the patient's pregnancy, including confirming the pregnancy status, checking health factors like medication use, allergies, and lifestyle choices, and setting up follow-up care with a midwife.

How does Dr. Gill ensure the safety of medications during pregnancy?

Dr. Gill evaluates whether the benefits of a medication, such as Citalopram for anxiety, outweigh potential risks, advising the patient to continue taking medications that are necessary for her well-being, with the option for further consultation with a specialist if needed.

Why is the patient asked about her blood pressure and hydration during pregnancy?

Blood pressure is monitored because pregnancy can affect it, and hydration is emphasized to prevent lightheadedness or dizziness, as the body's volume of blood increases during pregnancy.

What is the recommended treatment for common issues like pain during pregnancy?

Paracetamol is recommended for pain relief during pregnancy, while ibuprofen is avoided due to potential risks to the pregnancy.

What role does the midwife play in the pregnancy care after this consultation?

The midwife will continue the pregnancy care, providing further screenings, organizing scans, and guiding the patient through the next steps of prenatal care.

Why does Dr. Gill ask about the patient's work and stress levels?

Dr. Gill asks about the patient's work and stress levels to assess whether her job as a doctor, which can be stressful, might affect her pregnancy, advising her to seek support from her work and supervisor if needed.

What is the significance of checking the patient's weight and height?

Checking weight and height is part of calculating the patient's BMI (Body Mass Index), which helps assess overall health and potential risks during pregnancy.

How does the doctor address the patient's mental health during the consultation?

Dr. Gill inquires about the patient's anxiety and whether her current medication is helping. The doctor advises continuing with the prescribed medication to ensure the patient's mental well-being, which is important for the health of both the mother and the baby.

What vaccinations and health precautions are mentioned during the consultation?

The patient is confirmed to be up to date with the flu, COVID-19, and tetanus vaccinations, with further recommendations for vaccinations during later stages of pregnancy and screening for asymptomatic urinary bacteria.

What lifestyle habits are recommended for the patient during pregnancy?

The patient is advised to avoid alcohol, smoking, and recreational drugs during pregnancy, as these can harm both the mother and the baby.