Nursing care of a woman with triplet pregnancy and cervical insufficiency after in vitro fertilization according to Roy Adaptation Model: Case report

Abstract

In vitro fertilization (IVF), which is defined as the process of fertilizing the oocyte cell and sperm cell in the laboratory and then implanting the resulting embryo into the uterus, is a commonly used procedure in which multiple pregnancy complications are common. Multiple pregnancies are among the risky pregnancy group and are one of the factors that cause uterine overstretching. It is thought that overstretching of the uterus often increases the pressure on the cervix and increases the susceptibility to cervical insufficiency. When this condition develops, the pregnancy is at risk and the pregnant woman may require prolonged hospitalization. In these and similar complicated risky pregnancy cases, providing nursing care based on a specific model may enable individuals to adapt to the disease and pregnancy process. A 23-year-old woman, married for two years, was treated with assisted reproductive techniques and her first IVF treatment resulted in pregnancy. As a result of the treatment, monozygotic triplet pregnancy occurred and the patient was diagnosed with cervical insufficiency. Appropriate nursing diagnoses were determined for the case evaluated in accordance with the Roy Adaptation Model. Accordingly, the patient was diagnosed with deterioration in physical mobility, deterioration in sleep pattern, unbalanced nutrition, inability to fulfill self-care in the physiological field; weakness, anxiety, ineffective coping, situational low self-esteem, lack of information in the field of self-concept; inability to fulfill roles in the field of role function, risk of inadequacy in parenting; interruption of family processes and social isolation in the field of interdependence and appropriate nursing care was provided. As a result of the care provided, it was observed that the use of this model increased the patient's compliance with both the interventions and the prolonged hospitalization pro