Description

Gloria Smart is a 75-year-old African American female who presents to the office for regular GYN care. Medical history includes cardiac stent at age 55, mild hypertension, up to date with colonoscopies, last DXA normal. Surgical hx include tonsillectomy as a child and bunion removal. Home medications include Zocor, Plavix, and lisinopril. Social history includes works full time which is by choice because it makes her feel young, negative for tobacco or recreational drug use, drinks wine occasionally. Ms. Smart has never been married, she has been with her current partner for 2 years and will be getting married in 2 months. Reproductive history includes first menses at age 14, menopause at age 54, normal pap history and last mammogram was normal. Ms. Smart has never been pregnant or had a child.

As I start to talk to Ms. Smart, she relates that she and her finance have been talking about wanting to have a child as her fiancé also never had a child. She verbalizes reading an article about a woman in Canada who had a child at age 80 and another woman who had a child at age 78 in India. Pt. wants referral and some guidance.

Ms. Thomas was able to get pregnant through IVF and a donor egg during their second cycle, however she visited the clinic again for rib pain, swelling on her face and legs. Testing was done, LFTs and platelets were abnormal, Pt. started on magnesium sulfate infusion and labetalol for blood pressure control. However, her water broke during her visit, and she delivered a boy who lived for approximately 20 minutes. Ms. Thomas was discharged home on day 11 after difficulties managing her blood pressure and anuria.