Whoa

Uretero What? A Systems-level View of a Pregnancy with

Medical Complications

Part I— Gynecological Health Issues

Yvonne has been a student of science nearly all her life. She values her independence and loves her career in the

biopharmaceutical industry. She is extremely focused, as evidenced by her three-, fi ve-, and -year plans for

her career. Her plans include having a child, once she has realized her career aspirations.

Yvonne’s recent promotion to senior principal scientist at the young age of  means she now has more

responsibilities at work. She feels a deep sense of security as her dreams are coming to fruition. However, she is

about to learn that the best laid plans have a way of, well, not working out as planned.

Seldom needing to see a doctor for most of her life, Yvonne has spent the past several months receiving

gynecological treatment for cervicitis and cervical neoplasia, a disease for which the cause is unknown. A couple

of weeks ago, Dr. James Trent, her gynecologist/obstetrician, ordered several tests and performed an in-offi ce

diagnostic procedure to try to narrow down the cause of Yvonne’s condition.

At her next scheduled appointment, Dr. Trent tells Yvonne that the tests for bacterial or viral causes (which

would indicate the presence of a sexually transmitted disease, or std) are negative. He explains that the

procedure Yvonne had undergone last month, a colposcopy with cervical biopsy to evaluate the cervical

topography and its epithelial character, is benign for cervical cancer.

“Th e results are promising,” Dr. Trent explains, “but I am afraid that at this point we have more questions then

answers. I believe our best course of action is an outpatient procedure called cervical cryosurgery.”

“What is the intent of the surgery?” Yvonne asks.

“With cervical cryosurgery, we remove the superfi cial layers of tissue lining the cervix in hopes of permanently

removing any abnormal cells, whatever their cause, thereby...