OBSTETRICAL HISTORY

DURING PRENATAL VISITS

(NCM 107-LABORATORY
LECTURE)
 Physical examinations generally consist
of:
 Collection of (mother's) medical history

 Checking (mother's) blood pressure

 (Mother's) height and weight

 Pelvic exam

 Doppler fetal heart rate monitoring

 (Mother's) blood and urine tests

 Discussion with caregiver

 VIDEO CLIP

 LINK:
https://www.youtube.com/watch?v=DvcDXvlCXAE
Goals of antenatal care
 1. The main goal is the safety and
welfare of the mother and her
fetus during the entire gestation
(conception to birth)
 2.The preparation of mother for
labor, and lactation.
 3.The early detection and
appropriate treatment of high- risk
conditions.
 4.The reduction of maternal and
infant mortality, and prematurity.
Components of antenatal care

Registration
History taking
Obstetric Examination
Clinical service
Health Education
Immunization
Registration of Antenatal visits

Booking visit: to be at 6th week of

gestation
6th – 28th week : to be very 4
weeks
29th – 36th week: to be every 2
weeks
36th up to delivery: to be weekly
 The World Health Organization (WHO)
recommends a minimum of four antenatal visits.

 At least 4 routine antenatal visits

 1st visit: before 4 months

 2nd visit: 6 months

 3rd visit: 8 months

 4th visit: 9 months

 Expected weight gain during pregnancy

 Total weight gain: 20-25 lbs average: 24 lbs

 First timester : 1 lb per month: 3-4 lbs total
 Second trimester: 0.9 to 1 lb per week: 10- 12 lbs
 Third trimester: 0.5-1 lb per week: 8-11 lbs

 Note: Normal weight gain patterns contributes to health

of mother and fetus
 Weight is therefore a measure of health of a pregnant
mother
OBSTETRIC
HISTORY
1-General information

 Name, age , gravidity, parity, LMP, EDD

 Gravidity - refers to the no. of pregnancies including

current pregnancy (regardless of the outcome or
abortion)

 Parity - refers to the no. of births beyond 24 wk

gestation
 Components of an obstetrical history

 Precedingpregnancies and prenatal

outcomes (TPAL)

 T- number of full term births

 P- number of premature birth
 A- number of abortions
 L – number of currently living children
Number of pregnancies

 Gravida- refers to the number of pregnancies

regardless of duration and outcomes,
including the present pregnancy

 Gravida 1 - pregnant for the first time

 Primigravida - had one pregnancy

 Nulligravida - woman who is not and never has

been pregnant
 Parity – number of pregnancies carried to
period of viability (whether born dead or alive
at birth) twins considered as one

 A. Primipara- a woman who has delivered once

of a fetus or fetuses who reached the stage of
viability

 Any abortion is not included in the counting of

parity

 B. Multipara- a woman who has completed two

or more pregnancies to the stage of viability
2-Current problem/ complaint

3-History of current complaint

4-History of current pregnancy details of

the 1st ,2nd & 3rd trimester
** lab tests & U/S scans pattern
5-Menstrual & gynecological history

 LMP details ( was it conform to the usual in terms

of timing, volume, and appearance)

 Regular or irregular cycles

 Length of the cycle

 Surgical procedures

 Health of infertility

 Sexually transmitted diseases

6-Past obstetric history

 Outcome of previous pregnancies in

details including the abortions
 Any significant antenatal, intrapartum or
postpartum events
 Previous maternal complications
 Mode of delivery
 Baby Weight
 Life & health of the baby
7. Past medical/ surgical Hx
 Some medical conditions may have impact on the course of the
pregnancy or the pregnancy may have an impact on the medical
condition examples:
 Heart disease

 Hypertension

 DM

 Epilepsy

 Thyroid disease

 Bronchial asthma

 Any previous surgery.

 Kidney diseases

 UTI

 Autoimmune disease

 Psychiatric disorders

 Hepatitis

 Venereal diseases

 Blood transfusion
8.Drug Health

9.Family Health

 Hereditaryillness → DM., thalassemia, sickle

cell disease, hemophilia

 Congenitaldefects eg. neural tube defects, Down

syndrome, history of twins

 SocialHealth → Cigarette smoking, illegal drug

use, domestic violence, housing condition.