H/O present illness of uterovaginal prolapse (without decubitus ulcer):

According to the statement of the patient, She was reasonably well ...
years back. Then she noticed something coming down per vagina.
Initially it was within the vagina & respositioned spontaneously. After
that it comes down per vagina during straining. Now, it always remains
outside of the vagina & has to be respositioned manually. She has no
history of chronic cough, constipation & fever. She also has no history
of urgency & frequency of micturition. With the above complaints, she
got admitted to SHMCT for better management.

H/O present illness of normal puerperium (NVD):

According to the statement of the patient she was pregnant for 40
weeks. She was regularly menstruating woman. Her LMP was on ...
Accordingly, her EDD was on ... which was confirmed by early
ultrasonogram at 10 weeks. She was duely immunized against tetanus.
Regarding her antenatal history, it was her planned pregnancy & she
was on regular antenatal checkup & her pregnancy period was
uneventful. Two days back, she got admitted to SHMCT at her 40 weeks
of pregnancy with labour pain. She delivered a male baby per vaginally
with the aid of episiotomy approximately 4 hours after admission. Now
she has mild pain around the episiotomy area which is dull in nature &
per vaginal bleeding is average in amount & not foul smelling. She
changes 2-3 pads per day. She has no complaint of fever & pain in the
breast. Her bowel & bladder habit is normal. Her baby is on exclusive
breast feeding. With the above complaints, she got admitted to SHMCT
for better management.

H/O present illness of fibroid uterus:

According to the statement of the patient, she had normal menstrual
cycle with normal flow 2 years back. Her menstrual cycle was 28-30
days lasting 5-7 days with average flow. But for last 2 years the amount
of blood loss was increasing gradually lasting 10-15 days & requiring
average 8 pads/day & sometimes there were passage of clot. She gave
no history of pain during menstruation & sexual intercourse. She also
felt heaviness in lower abdomen & noticed a swelling in lower
abdomen for 1 year which is gradually increasing in size & not painful.
Her bowel & bladder habit is normal. With the above complaints, she
got admitted to SHMCT for better management.

H/O present illness of anemia in pregnancy:

According to the statement of the patient, she was pregnant for ...
weeks. Regarding her antenatal history, she was not on regular
antenatal check up & did not take any supplementation like folic acid.
Her pregnancy period was uneventful till 15 days back. Then she
noticed generalized weakness & palpitation which was aggravated by
doing work. Now, she is unable to do normal activities due to
weakness. With the above complaints, she got admitted to SHMCT for
better management.

Incomplete Abortion
C/C:
1 H/O amenorrhoea for 9 weeks
2. Passage of fleshy mass per vagina 2 days back
3. Slight per vaginal bleeding for 2 days
4. Mild lower abdominal pain for 2 days

H/O present illness of incomplete abortion:

According to the statement of the patient, she was amenorrhoeic for 9
weeks. She was regularly menstruating woman. Her LMP was on ...
Accordingly, her EDD will be on ... , which was confirmed by early USG.
She was duely immunized against tetanus. Regarding her antenatal
history, she had no antenatal check up & her pregnancy peroid was
uneventful upto 2 days back. 2 days back, she noticed per vaginal
bleeding & passage of fleshy mass per vagina. She also has mild lower
abdominal pain for 2 days. With the above complaints, she got
admitted to SHMCT for better management.

4 Grip
Cephalic presentation
On fundal grip, there is broad, soft, irregular structure resembling to
fetal buttock.
On right lateral grip, there is smooth, curved like structure resembling
to fetal back.
On left lateral grip, there is irregular knob like structure resembling to
fetal limb.
On 1st pelvic grip, there is rounded, smooth, hard like structure
resembling to fetal head.
By 2nd pelvic grip, engagement of head is known