By Geri Morgan CNM ND, Carole Hamilton MA CNM
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Extra info for Practice guidelines for obstetrics & gynecology
Amenorrhea a. Rule out pregnancy. b. If patient is not pregnant, reassure her that amenorrhea is a known side effect of the pill. 6. Heavy bleeding a. Rule out other causes: STDs, cervical problems, pregnancy, uterine fibroids, and cancer. b. If all normal, offer ibuprofen (Motrin) 600 to 800 mg orally three times a day for 5 days. c. Consider changing to a combined BCP or other form of contraception. XIV. Spermicides A. Definition: Spermicides are chemical agents that inactivate the sperm in the vagina.
B. If the screen reveals abnormal results, perform a thyroid panel and consult as necessary. 56 XVI. Blood Sugar Tests A. Order a 1-hour post 50-g glucola load. 1. Administer test preferably between 24 and 28 weeks. 2.
2. Cervical mucus a. The cervical mucus method is based on the following facts: (1) Mucus produced by the cervical cells changes during the menstrual cycle. (2) After the period, when estrogen is low, mucus is scant. If present, it is sticky and opaque with cellular matter. (3) As estrogen levels increase, the mucus increases in amount. It becomes thinner and milkier. (4) Just before ovulation, estrogen peaks. The mucus is high in volume and clear. 33 being able to stretch an unbroken thread between fingers; this is called spinnbarkeit.