Form No: F/AAC/10

KARPAGAM HOSPITAL Rev. No: 00

OTHAKKALMANDAPAM, COIMBATORE - 641032
Page No: 1 of 4

DISCHARGE SUMMARY

DEPARTMENT OF OBG Barcode

NAME: MRS.ABI AGE: 21 SEX: FEMALE

DEPARTMENT: OBG UNIT: 3 WARD: F1 F2
OP NO:9000279561 IP NO. 902304260001
PATIENT’S ADDRESS 50, BHARATHI NAGAR, EACHANARI, COIMBATORE

CONTACT 7418098827
NUMBER(S)
ADMISSION: DATE 26/04/23 TIME: 08.59 PM
DISCHARGE: DATE: 29/04/23 TIME: 04.00 PM

TREATING DOCTORS:
DRUG ALLERGIES: NIL
 DR.KARTHIKA J MS OBG BLOOD GROUP : B POSITIVE
 DR.DIKSHA MS OBG
 DR. PRIYADHARSHINI DNB OBG

DIAGNOSIS: PRIMI / 33 WEEKS + 3DAY/ FEVER FOR EVALUATION.

CHIEF COMPLAINTS: C/O VOMITING AND FEVER SINCE NIGHT (25/04/23). FM PERCEIVED.

H/O PRESENTING ILLNESS: PATIENT PRESENT WITH COMPLAINTS OF VOMITING FOR

ABOU 4-5 EPISODES, INTERMITTENT, NON BILIOUS, INTOLERANT TO ANY ORAL INTAKE.
H/O FEVER WHICH WAS GRADUAL IN ONSET. ACUTE AND INTERMITTENT IN NATURE.
CONTINUES TO PERCEIVE FATAL MOVEMNT. NO H/O BLEEDING PV OR LEAKING PV.

HISTORY OF PRESENT PREGNANCY:

LMP: 04/09/2022

EDD: 11/06 /2023

GESTATIONAL AGE: 33 WEEKS 3 DAYS [ON ADMISSION]

BOOKED AND IMMUNIZED.

1ST TRIMESTER:

SPONTANEOUS CONCEPTION
CONFIRMNED BY UPT
FOLIC ACID TABLETS TAKEN REGULARLY
DATING SCAN NORMAL,
NT SCAN DONE & NORMAL

For Emergency: Contact Casualty/Emergency Department of our hospital 0422-2904453

அவசரஉதவிக்கு: எங்கள்மருத்துவமனையின்விபத்துமற்றும்
 Form No: F/AAC/10
KARPAGAM HOSPITAL Rev. No: 00
OTHAKKALMANDAPAM, COIMBATORE - 641032
Page No: 2 of 4

DISCHARGE SUMMARY

2ND TRIMESTER:

QUICKENING FELT AT 20 WEEKS.

TT IM 2 DOSES TAKEN
IRON AND CALCIUM TABLETS TAKEN REGULARLY
NO H/O SPOTTING & BLEEDING PV, NO H/O EPIGASTRIC PAIN, HEADACHE, FEVER,
BLURRING OF VISION
ANAMOLY SCAN DONE AND NORMAL

3RD TRIMESTER:

ABLE TO PERCEIVE FETAL MOVEMENTS

GROWTH SCAN TAKEN- NORMAL,
IRON AND CALCIUM TABLETS TAKEN.
NO H/O BLEEDING / LEAKING PV/PEDAL EDEMA. HAD ANTENATAL VISITS OUTSIDE TILL 33
WEEKS (VENKETESHWARA MEDCITY, CHENNAI). GROWTH SCAN HERE AT 33 WEEKS,
NORMAL.

C. MENSTRUAL HISTORY: AOM: 15 YEARS, REGULAR CYCLE 5-6/30DAYS, NOT ASSOCIATED

WITH CLOTS, PAIN.

MARITAL HISTORY: MARRIED FOR 3 YEARS.NON CONSANGUINEOUS MARRIAGE, NO H/O

CONTRACEPTION USAGE.

F. PAST HISTORY: K/C/O HYPOTHYROID FOR 3 YEARS ON MEDICATION T.THYRONORM

125MCG 1-0-0.
POLPYPECTOMY DONE (2019)
HYSTEROLAP (2021) WAS DONE AND SUBMUCOSAL POLYP REMOVED.
NOT A KNOWN CASE OF SHTN/DM/ASTHMA/EPILEPSY/CAD.

G. PERSONAL HISTORY: MIXED DIET, SLEEP AND APPETITE NORMAL. BOWEL HABITS
REGULAR.

H. FAMILY HISTORY: NIL SIGNIFICANCE

O/E: CONSCIOUS, ORIENTED. FEBRILE, DEHYDRATION +

NO PALLOR, CYANOSIS, CLUBBING, ICTERUS, LYMPHADENOPATHY, PEDAL EDEMA.
BP: PR: RR: SpO2: T⁰F:
110/70 86 b/min 18/min 99% 100.6 F
mmHg

SYSTEMIC EXAMINATION:

CVS: S1, S2 HEARD

For Emergency: Contact Casualty/Emergency Department of our hospital 0422-2904453
அவசரஉதவிக்கு: எங்கள்மருத்துவமனையின்விபத்துமற்றும்
 Form No: F/AAC/10
KARPAGAM HOSPITAL Rev. No: 00
OTHAKKALMANDAPAM, COIMBATORE - 641032
Page No: 3 of 4

DISCHARGE SUMMARY

RS: NVBS, B/L AE PRESENT

CNS: NFND.
PA: SOFT, UTERUS- 30 WEEKS SIZE. ? CEPHALIC. FHS – GOOD
TERM/CEPHALIC/RELAXED/FHS-178BPM.

INVESTIGATIONS:

LABORATORY: CBC, F.T3, F.T4, F.TSH, URINE ROUTINE , VDRL

USG – GROWTH SCAN ; (27/04/2023);

 SINGLE LIVE INTRAUTERINE OF APPROXIMATE GA 32 WEEKS AND 4 DAYS WITH

FETAL TACHYCARDIA. FETAL HC < 10TH PERCENTILE
FHR-189 BPM, EFW-1958 GMS +/- 286 GMS, AFI-8.8 CM, PLACENTA- ANTERIOR

INHOSPITAL MEDICATIONS:

1. IVF.FLUIDS
2. INJ CEFTRIAXONE 1G IV BD
3. INJ PARA 1G IV SOS
4. INJ PAN 40 MG IV OD
5. INJ EMESET 4MG IV BD
6. T. AZITHROMYCIN 500 MG OD
7. T.PARACETAMOL 650 MG
8. T.PAN 40 MG OD
9. T.DOLO 650 MG SOS
10. SYP. ASCORIL DX 5ML TDS

CASE SUMMARY:

MRS ABI 21 YEARS OLD PRIMI [33WEEKS + 3DAYS] CAME WITH COMPLAINTS OF
VOMITING AND FEVER SINCE EVENING(28/03/2023). SHE WAS ADMITTED FOR FURTHER
EVALUATION AND MANAGEMENT. ROUTINE INVESTIGATIONS WERE SENT. ON
ADMISSION SHE HAD MATERNAL AND FETAL TACHYCARDIA. MEDICINE OPINION WAS
OBTAINED AND ORDERS WERE FOLLOWED. COUNTS MILDLY ELEVATED HENCE STARTED
ON ANTIBIOTICS. SHE WAS TREATED CONSERVATIVELY AND WAS UNDER OBSERVATION.
PATIENT ASYMPTOMATIC FOR >48 HOURS. FETAL AND MATERNAL SURVEILLANCE DONE,
NORMAL AND PATIENT CONDITION IMPROVED. HENCE, DISCHARED.

CURED TREATMENT COMPLETE NOT CURED DEAD

IMPROVED AMA DISCHARGE AT REQUEST DISCHARGE

ABSCONDED

For Emergency: Contact Casualty/Emergency Department of our hospital 0422-2904453

அவசரஉதவிக்கு: எங்கள்மருத்துவமனையின்விபத்துமற்றும்
 Form No: F/AAC/10
KARPAGAM HOSPITAL Rev. No: 00
OTHAKKALMANDAPAM, COIMBATORE - 641032
Page No: 4 of 4

DISCHARGE SUMMARY

WHEN TO OBTAIN URGENT CARE :

 ABDOMINAL PAIN, FEVER, DECREASED FETAL MOVEMENTS,

 BLEEDING / LEAKING PV

ADVICE ON DISCHARGE:

 DIET: NORMAL DIET

 STRICT DFMC

S. NO NAME OF THE DOSAGE MORNIN AFTER NIGH DURATIO BEFORE

DRUG G N0ON T N FOOD/ AFTER
FOOD
1. T.CEFEXIME 200 MG 1 0 1 3 DAYS AFTER FOOD
2. T PAN 40 MG 1 0 0 3 DAYS BEFORE FOOD
3. T. IRON 200MG 1 0 0 30 DAYS AFTER FOOD
4. T.CALCIUM 500MG 0 1 0 30 DAYS AFTER FOOD
T.AZITHROMY 500 MG 1 0 0 2 DAYS AFTER FOOD
5.
CIN
T. DOLO 650 MG 5 TABS
6.
SOS
DATE OF REVIEW: REVIEW IN OBG OPD ON 05/05/2023 WITH FBS, PPBS REPORT.

SUMMARY PREPARED DR PARVATHY MURALI KV CRMI

BY
SUMMARY CHECKED DR.KARTHIKA MS OBG AP
AND APPROVED BY
DR.DIKSHA MS OBG SR

DR.PRIYADHARSHINI DNB OBG SR

For Emergency: Contact Casualty/Emergency Department of our hospital 0422-2904453

அவசரஉதவிக்கு: எங்கள்மருத்துவமனையின்விபத்துமற்றும்