Obstetric History

difficult skill to master

experience 2 practice

more components than normal

medical history

Privacy and confidentiality

ex home members women

present not
willing

Imp terms

1 Gravidity

number of pregnacies

including current one

2 Parity

Pregnancies that resulted in

delivery beyond 24 weeks gestation

ex

para 2 1

By

she had 2 pregnancies 1 which ended

beyond 24 completed prior to 24

weeks weeks

OTI didst MF pregnant niet

MT
IT
f pregnant

311T at

Gravida 3

fu

Gravida 4

Twins Parity
311 asf
Actually controversy

parity 2

parity 2 or

Gravidy I

3 Dating a Pregnancy

Normal LMP 4124740W

pregnancy

EDD Expected date of delivery

EDD LMP HEI 1 d 101993T

rueBHT 2yr 7days
adddaiao fa not oxford
Naegele's

Add cp2 µ gait 1yrtodays

HIT accurate

cUlcLT 3 H1E dolt darted

LMP 1 Jan 2020

1 yr todays

1000202

34140T obstetric History

Chapter Adit 311T

Obstetric History ob2

96141 of 31140T

AGT

Current Pregnancy

name age occupation

gravidity parity LMP EDD

Irregular cycles long cycles

fetal movement if 20 weeks

tests scans

routine blood tests 1St tri scan

at 20 weeks
anomaly scan

Pastobstetristory

details of previous pregnancies

miscarriages and terminations

reasons for

termination

Antenatal problems

date place of delivery

birth wt i delivery complications

including shoulder dystocia

haemorrhage stillbirth

Dont forget to ask postnatal

period and neonatal life

Shoulder dystocia is when, after vaginal delivery of the head, the baby's anterior shoulder gets caught
above the mother's pubic bone. Signs include retraction of the baby's head back into the vagina,
known as "turtle sign". Complications for the baby may include brachial plexus injury, or clavicle
fracture.

gynaecologicd.me SugeryHistory

contraception

Gynaecological problems

Disorders Asthana DM HTN

surgical history

DrugHistorgy
allergies
safe 2 unsafe drugs

Familythstory
Social History addict ons
domestic violence
 Abdominal Examination

Symphysis fundal height SEH

inurn

Uterus not pla until 12 weeks

felt
By 16 weeks half way beth
symphysis pubis and umbelicus
20 24 weeks fundus reaches umbelic
36 week fundus is under the ribs
At term lies a bit lower than 36W
as head descends into
the pelvis
from 16 weeks SfH increases
1cm week
on inspecting the abdomen

size asymmetry fetal movement

Signs line of pigmentation
a
linea nigra extending in the
midline from pubic hair to
Umbelicus
Striae gravidarum stretchmarks
New purple
Old silvery white
surgical marks

Palpating the abdomen

measure SFM after 20 weeks

estimate no of fetuses
fetal lie Longitudinal
Oblique
Transverse
 Physiological changes in Pregnancy

Hormonal changes

Oestrogen breast nipple growth

water retention
protein synthesis
maternal thyroid enlarged due
to colloid production
1
Thyroxine level
t
Thyroid disease in pregnancy

Genital changes
late pregnancy cervical collagen
reduces
A mucus production from
vagina

Haemodyanamic Changes
t plasma volume I
from 10 weeks Hb falls due to
Red cells 918 I dilution Physiologicalanaemia
no iron supp I
 up
A WBC platelets gamm globulin falls
ESR Cup4fold Urea creath
Cholesterol

cardiovascular changes

St Cardiac Output r from slit min to

o weeks
6.5 7 lit min
pulse rate r 15 beats min

Bp 2nd trimester diastolic by 10 20mmHg

4 venous pressure varicose veins
may forms

Otherchanges
Frequency of micturation 9
Early due to glomerular
filtration rate t by 60
Late due to bladder pressure
9
by fetal head
Skin Pigmentation A
Urine Pregnancy Tests

ve from 9 days post conception

LMP unit 23 2815925187
OPT trophoblastic disease HETYOT
3125219T

Pre pregnancy counselling

aim risk factors at alot

1112 to 2 auf Hot get at lowest rate of
perinatal problems

Stop smoking
reduce ovulation
fallopian tube functioned
rates of miscarriage a

Weight Loss 18.5 30BM

Exercise Avoid Abdominal

injury chances
Folic Acid supplementation
folate rich foods t folic
acid Orang daily I month
preconception till 13 wks
1
Neural tube detect
a cleft palate at chances and
art
5mg day of NTD antiepileptic
obese HIV patient 3124T MT
Avoid Liver Vit A
t
Vita embryopathy
affine LL
Soft cheese shellfish sawfish
Avoid

Vit D supplimentation
Risky pts tied

Avoid Alcohol
 Pre existing medical Disorders
31172 913 Limit
specialist at refer assist
Halit Eliot 314TH pregnancy
avoid or Abortion

Medication
e
specialist art consult
to minimise dose

over the counter Homeopathic

herbal medicine avoid

Genetic counselling

Spontaneous miscarriage
Risk of miscarriage 15 20
of all pregnancies

n
Agent miscarriage
 ThePlacenta
organ of respiration nutrition
and excertion for the fetus

Immunity allows of
passage
maternal IgG antibodies

at term the placenta weighs

116th the weight of the
baby

Uterus relieves 500 600m min

if it decrese
for any reson
I
IUGR Pre eclampsia