Adolescent pregnancy Flashcards
What are the pregnancy rates among Canadian adolescents in 2003?
<20yo 27.1 per 1000
18-19yo 54.1 per 1000
15-17yo 16.8 per 1000
<15yo 2.0 per 1000
How many adolescent pregnancies end in induced abortion?
Just over 50%
What are some symptoms of pregnancy?
- menstrual irregularities
- nausea
- vomiting
- fatigue
- abdominal pain
When can hCG be detected in serum?
As early as 6 days post-conception
When can hCG be detected in urine?
Monoclonal antibody detection as early as 10-14d after ovulation
May not detect pregnancy until 1wk post missed period
Confirm negative w/ serum tests
What other tests are useful in diagnosing pregnancy?
Bimanual pelvic examination, uterus is palpable above pelvic bone @ 9-12wks GA
US to determine dates
What should health practitioners assess when taking a history from a pregnant adolescent?
- inquire about physical and emotional effects of her pregnancy
- determine her knowledge of the options and her feelings about these options
- explore any family, cultural or community issues
- when appropriate, explore her partner’s opinion about the options and discuss his role in the young woman’s decision-making progress
- establish the extent of her support system
- assess for any underlying health issues and for any complications
- assess for current substance use and high-risk health behaviours
- review housing and school status and personal and academic goals
What should health care practitioners counsel adolescents on who plan to continue the pregnancy?
- refer the adolescent to appropriate resources: maternity homes, drop in centres, and support groups
- encourage continuing education
- encourage, if appropriate, the presence of the baby’s father and/or her current partner in the f/u
- in the case of young women who choose adoption, refer them to an adoption service that provides counseling and support
- stay in contact with all mothers (if they keep their babies or not)
- provide contraceptive counseling
- advocate for high-quality subsidized child care and for flexible school programs
What percentage of adolescents who delivery will have another pregnancy within the following two years?
35%
What should HCP counsel adolescents who plan to terminate the pregnancy?
- information about the specific procedures available
- anticipatory guidance about common emotional response, i.e. grief, relief, anger
- referral to appropriate medical and surgical services
- appointments for f/u that include a review of any complications such as excessive bleeding, fever, cramps after the 1st 48h, abnormal discharge, physical and emotional concerns and contraceptive f/u
What are the characteristics of more effective programs for preventing unplanned adolescent pregnancies?
- longitudinal f/u
- provision of continuum of options from abstinence to contraceptive information
- life skills training
Which adolescents are at risk for unprotected intercourse?
- experiencing social and family difficulties
- whose mothers were adolescent mothers
- undergoing early puberty
- who have been sexually abused
- with frequent school absenteeism or lacking vocational goals
- with siblings who were pregnant during adolescence
- who use tobacco, alcohol, and other substances
- who live in group homes, detention centres or are street-involved
What are the CPS recommendations to HCP?
- counsel pregnant adolescents in a non-judgmental way about their pregnancy options. if they are unable to do so, they should refer to others who can provide this service
- attempt to protect adolescents from being coerced into any option against their will
- help the adolescent to develop a supportive network
- make f/u appointments
- ensure that adolescents referred to another practitioner or service have made and kept their appointment
- respect the adolescent’s right to privacy and medical confidentiality
