Module Title  6  Management of Early Pregnancy

Intended Audience

This educational activity is designed for nurses and other healthcare providers with an interest in women’s health, reproductive endocrinology and infertility.

CE approval period: June 16, 2023 – June 16, 2025

Estimated Time to Complete this Activity:  1.0 hour

Program Description/Identification of Need

Nurses in reproductive endocrinology and infertility (REI) and assisted reproductive technology (ART) settings provide education, counseling, support, and direct nursing care to patients seeking assistance with conception. Surveyed nurses reported that most of their time in the clinical setting was spent in teaching clients. They reported that assessing clients’ knowledge deficits, providing instruction and anticipatory guidance, offering therapeutic support, offering compassion, and explaining test results and treatment options were their primary roles.  The areas they ranked as essential to practice were knowledge of anatomy and physiology, the normal menstrual cycle, pathophysiology, treatment options, and diagnostic tests, and skills in patient teaching, counseling, history taking, physical assessment and ultrasound technique. 

This content of this module, Management of Early Pregnancy, provides core theoretical and practical information specific to the clinical area of REI practice as well as essential information for nurses and other health care professionals who provide reproductive health care for all women.  This evidence-based content will assist nurses to function in their roles safely and proficiently, ultimately contributing to improved quality of care and patient outcomes.

Educational Objectives

At the conclusion of this presentation, participants should be able to:

1.     Identify methods for monitoring first trimester pregnancies conceived after infertility treatment.

2.     Describe the basic physiologic changes in first trimester embryo and fetal development.

3.     Describe essential elements of patient education, counseling and anticipatory guidance in early pregnancy.

4.     Identify the psychological adjustments to pregnancy after infertility treatment.

5.     Explain the impact of infertility treatment on the risk of multiple gestations and describe consequences related to high-order multiples.

6.     Describe the diagnosis and management of ectopic pregnancy.

7.     Describe techniques available for prenatal aneuploidy screening and diagnosis.

8.     List methods of identifying early pregnancy loss with effective interventions and counseling.

9.     Identify appropriate patient resources and referrals.

 Approval Statement

This Activity has been evaluated and approved by the Continuing Education Approval Program of the National Association of Nurse Practitioners in Women’s Health for 1.0 contact hours of continuing education credit including 0.0 contact hours of pharmacology content.

NPWH Activity no. ___23-12.

Each participant should claim only those contact hours that he/she actually spent in the educational activity.

Disclosures

Planners

Content Contributors and Reviewers

·        Ruben Alvero, MD - Consultant: Cooper Surgical

·        Jodie L. Asher – Employee: Integrated Genetics

·        Valerie L. Baker – Institutional Support from IBSA

·        Samantha Butts, MD - Nothing to Disclose

·        Bruce Carr, MD – Grant/Research: Evofem, Abbott, Medicines360, Merck

·        Charles C. Coddington, MD -  Ownership/Stock: Gilead, Proctor and Gamble, Merck

·        William Catherino, MD – Research/Speaker for EMD Serono; Grant/Research for Bayer and Schering Pharma

·        Owen K. Davis, MD – Nothing to Disclose

·        Michael Eisenberg, MD – Consultant: Sandstone Diagnostics, Reprovantage, Galapagos, Abbvie

·        Leslie Francis, JD, PhD –  Independent Contractor and Advisory Board for Amgen

·        Elizabeth Grill, PsyD - Nothing to Disclose

·        Clarisa Gracia, MD  - Nothing to Disclose

·        Emily Jungheim, MD – Consultant: Abbvie, Genentech, Spectrum Pharmaceuticals, Celgene

·        Sigal Klipstein, MD – Nothing to Disclose

·        Sacha Krieg M.D.,Ph.D. – Nothing to Disclose

·        Benjamin Lannon, MD - Stock ownership: Dyax Corporation

·        Mark Licht, MD - Nothing to Disclose

·        Janet McLaren Bouknight, MD - Nothing to Disclose

·        Samantha M. Pfeifer, MD – Consultant: Best Doctors

·        Thomas Price, MD – Grant/Research: Bayer Pharmaceutical, Vivere Health; Consultant: GuidePoint, MedaCorp, Gerson Lehman Group, Best Doctors Consultant

·        Gail S. Prins, PhD, HCLD - Nothing to Disclose

·        Elizabeth Puscheck, MD  -  Research Grants for Wyeth and Ethicon

·        Richard H. Reindollar, MD – Nothing to Disclose

·        Ginny L. Ryan, MD, MA - Nothing to Disclose

·        Jay Sandlow, MD - Nothing to Disclose

·        David Shin, MD - Speaker's Bureau: Endo Pharmaceutical

·        James F. Smith, MD - Nothing to Disclose

·        Steven J. Sondheimer, MD – Speakers Bureau: Schering-Plough/Merck, Bayer

·        Laurel Stadtmauer, MD – Speakers Bureau: Watson Pharmaceuticals

·        Helen Tempest, PhD – Nothing to Disclose

·        Michael A. Thomas, MD – Consultant for Watson Pharmaceuticals; Grant/research:  Ferring, Medicines 360, Berlex, EvoFem

·        Thomas Toth, MD – Consultant: Good Start Genetics

·        Angela Trepanier, MS, CGC – Nothing to Disclose

·        Carin Yates, MS, CGC - Nothing to Disclose

·        Eric Widra, MD – Stock Ownership – SG Patent Holdings, LLC; Consultant: Natera, Counsyl

Disclosure of Unlabeled Use

This presentation may contain discussion of unlabeled uses of a commercial product or an investigative use of a product not yet approved by the FDA for this purpose.

Disclaimer Information

The content and views presented in this educational activity are those of the faculty/authors and do not necessarily reflect those of the American Society for Reproductive Medicine. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity to make clinical decisions about individual patients.

Successful Completion Requirements

Successful completion of this Reproductive Endocrinology and Infertility Nursing Education Module requires the learner to:

·       View a course overview page, containing all CE and disclosure information, including acknowledgement of commercial support and disclosure of unlabeled use, prior to the start of each module.

·       Complete a 10-question pre-exam prior to the module. Learners should note any pre-exam questions answered incorrectly for clarification during module study.  

·       Be given the option of downloading a printed syllabus containing the presentation and narrative.

·       Participate in the interactive activity: Audio narration is synchronized with PowerPoint presentation that can be advanced, stopped or reversed as desired.

·       Complete a 10-question post-exam, with feedback of correct/incorrect answers, scoring a minimum of 70% in two attempts.

·       Complete the evaluation survey.

·       Print certificate of completion.

Commercial Support Acknowledgement

This program is supported by an educational grant from Schering Corporation, a subsidiary of Merck & Co., Inc.