Pediatric/Gynecologist Assignment: Preconception Health Risks Analysis

This homework assignment focuses on a case study of Monica, a 38-year-old African American woman with a history of pregnancy complications and several health concerns. The assignment requires an analysis of Monica's preconception health risks, including obesity, hypertension, hyperlipidemia, and her lack of knowledge regarding her family's genetic history. It explores the risks associated with her current medications, specifically an ACE inhibitor for hypertension, and identifies safer alternatives for potential pregnancy. The assignment also delves into specific genetic risk factors for which Monica should be screened, given her race and medical history. Furthermore, it proposes additional preconception health strategies, such as lifestyle modifications and dietary changes, to improve her overall health and increase the likelihood of a successful pregnancy. The student provides rationales for each answer, citing relevant research and medical literature, thus demonstrating an understanding of the interconnectedness of these health factors and their implications for reproductive health.

Running head: PEDIATRIC/ GYNECOLOGIST
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Pediatric/ Gynecologist
Students Name
Institutional Affiliation

PEDIATRIC/ GYNECOLOGIST
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Pediatric/ Gynecologist
Health experts around the globe have tried to define pediatric and gynecologist. However,
the most suitable definitions state that pediatric is the arm of medicine that deals with health and
medical care of infants, children, and adolescents between the ages of birth to 18 years.
Pediatrics conducts not only medical care for children but also provides preventive services for
healthy children. The study of pediatric is aimed at reducing the death rate of children. On the
other hand, a gynecologist is a specialist that conducts medical practice dealing with female
reproductive system health. Gynecologists use the Pap smear test to detect abnormalities in the
female reproductive system.
Having read the story of Monica, below are the answers to the questions give:
Which three of the preconception health risks do Monica have?
From the mentioned preconceptions, Monica is struggling with obesity, hypertension, and
hyperlipidemia, and also she is unaware of her family's genetic risk history. From the
explanation, it is clear that she has the hormone that causes obesity. There are several hormones
that are responsible for weight gain in women; for instance, estrogen hormone helps an
individual to control metabolism and body weight. A high level of this hormone will irritate
insulin-producing cells in the body; as a result, body cells block insulin, letting the uncontrolled
amount of glucose circulate. This will lead to obesity and hypertension (Hall et al. 2015). Insulin
helps in the breakdown of fats when insulin is blocked, fats will grow in the blood vessels, and as
a result, the individual suffers from hyperlipidemia (Rahman et al. 2017). Monica's story stated
that new parents adopted her, and therefore she is not aware of her biological parents’ genetic
history.

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Which medication used to treat hypertension and/or cardiovascular disease has the
lowest risk and, therefore, would be considered the safest if an unintended pregnancy were to
occur?
Hypertension is mostly found at most 6% of young women (Foy et al. 2016). Its
treatment aims at decreasing cardiovascular risk, the astronomy of which is less dependent on the
level of blood pressure than associated cardiovascular risk factors hypertension-related organ
damage and concomitant disease. Hypertension diseases of pregnancy complicate up to 10% of
pregnancies. This leads to maternal and perinatal mortality (Verbiest and Woodward, 2016).
Therefore, from the given medicines, hydralazine is the right medicine to treat hypertension and
cardiovascular disease (Laurent et al. 2017). Hydralazine is better than an ACE inhibitor that her
medical provider prescribed. This is because ACE inhibitor, which includes Lisinopril, is one of
the worst blood pressure drugs, and it will bring higher risk to her in case she is pregnant.
Pregnant women are advised to avoid Atenolol medicine as it goes through placental barrier, thus
appearing in cord blood. This affects pregnancy may lead to miscarriage.
As Monica does not know her biological family’s genetic risk history, what primary
genetic risk factor based on her race or ethnicity would you most want to screen her for during
preconception?
Findings suggest that the race of an individual is the most important aspect considered by
physicians when making decisions on preconception testing (Franasiak et al. 2016). Biologists
say that individuals whose parents have hypertension are at more risk of developing the
condition. This is particularly if both parents have hypertension. This is because hypertension is

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hereditary (Still et al. 2018). Therefore, the only basic genetic factor I would research on is the
hypertension factors. Health experts have named hypertension as a consequence risk factor for
several cardiovascular diseases. It is a multiplex character that results from the interactivity of
many genetic as well as elements from the environment. Moreover, in the list of people who are
more likely to develop hypertension, African-Americans, pregnant women, and obese
individuals have been listed, all these factors making Monica in high chances of developing
hypertension. Unfortunately, hypertension is a chronic disease in that it can only be controlled
but not cured.
What other preconception health strategies would you recommend for Monica since she
is not actively planning a pregnancy now?
For Monica to have a successful pregnancy in the future, there are some preconception
health strategies she should apply. To lower her body mass index, she should engage herself in
body excises at least 30 minutes a day. Moreover, she should consider adopting the right diet.
The meals that will help her solve obesity include fruits, vegetables, and grains. Avoiding the
consumption of fatty and sugary meals will help her treat obesity. During her cooking, she is
advised only to use vegetable based oils and not animal-based fats.
Doctors have suggested that surgery helps in the treatment of obesity, however, this is an
expensive form of therapy, but it works best (Barker et al. 2018). On the other hand, there are a
couple of solutions to control hypertension. She should reduce the sodium amount in her diet,
reduce stress, and reduce the consumption of caffeine. She should stop taking ACE inhibitors
since they are named one of the worse medicine that controls hypertension. As for
hyperlipidemia, it is a treatable illness, but it takes a long time to ill. She is advised to take

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lovastatin as prescribed by health personnel (Verbiest and Woodward 2016). By so doing, she
will be in a position to rebrand her health and be able to give birth.
To conclude, it is right to say that Monica's birth parents were struggling with
hypertension. This is because this illness is hereditary and cannot be a cure. Apart from
hypertension, the rest of her illness is medically treatable, and others can be treated by some of
the home remedies like obesity. As discussed above, an ACE inhibitor is one of the worst class
of medicines that control hypertension, and they have health hostile side effects. People around
the globe should avoid those medicines to prevent these side effects. People are also advised to
adopt healthy lifestyles to prevent or control the illness. Healthy habits are known to prevent the
body of an individual from some health conditions such as high blood pressure and
cardiovascular diseases.

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References
Barker, M., Dombrowski, S. U., Colbourn, T., Fall, C. H., Kriznik, N. M., Lawrence, W. T., ... &
Sniehotta, F. F. (2018). Intervention strategies to improve nutrition and health behaviors
before conception. The Lancet, 391(10132), 1853-1864.
Foy, C. G., Newman, J. C., Berlowitz, D. R., Russell, L. P., Kimmel, P. L., Wadley, V. G., ... &
SPRINT Study Research Group. (2016). Blood pressure, sexual activity, and dysfunction
in women with hypertension: baseline findings from the Systolic Blood Pressure
Intervention Trial (SPRINT). The journal of sexual medicine, 13(9), 1333-1346.
Franasiak, J. M., Olcha, M., Bergh, P. A., Hong, K. H., Werner, M. D., Forman, E. J. ... & Scott
Jr, R. T. (2016). Expanded carrier screening in an infertile population: how often is
clinical decision making affected?. Genetics in Medicine, 18(11), 1097-1101.
Hall, J. E., do Carmo, J. M., da Silva, A. A., Wang, Z., & Hall, M. E. (2015). Obesity-induced
hypertension: interaction of neurohumoral and renal mechanisms. Circulation
Research, 116(6), 991-1006.
Laurent, S. (2017). Antihypertensive drugs. Pharmacological Research, 124, 116-125.
Rahman, H. A., Sahib, N. G., Saari, N., Abas, F., Ismail, A., Mumtaz, M. W., & Hamid, A. A.
(2017). Anti-obesity effect of ethanolic extract from Cosmos caudatus Kunth leaf in lean
rats fed a high-fat diet. BMC complementary and alternative medicine, 17(1), 122.
Still, C. H., Jones, L. M., Moss, K. O., Variath, M., & Wright, K. D. (2018). African American
older adults' perceived use of technology for hypertension self-management. Research in
gerontological nursing, 11(5), 249-256.

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Verbiest, S., McClain, E., & Woodward, S. (2016). Advancing preconception health in the
United States: strategies for change. Upsala journal of medical sciences, 121(4), 222-
226.