1 - O+G - Hx + Ex - Obstetric Hx

Question 1

first things to ask

Answer 1

personal details - name age occupation gestation gravida parity

then PC

Question 2

what are common PCs

three qus MUST ask in HPC

Answer 2

HTN, unstable lie, possible ruptured membranes

fetal movements? (>20wks)
abdo pain?
vaginal loss/bleeding?

Question 3

Parts of Hx specific to Obs Hx

Answer 3

Hx of present preg
-dates
-complx of preg
-tests
Past Obs Hx  
-Parity
-Gravidity

Question 4

Other parts of Hx not to miss?

Answer 4

past gynae hx
PMHx
SR
DHx + allergies
FHx
SHx
VTE risk

Question 5

Hx of present preg - dates?

Answer 5

LMP?
length of cycle?
regularity?
weeks gestation? (-2 wks since conception)
EDD? (LMP -3m +7d + 1y OR use obs wheel) (EDD later/earlier if cycle >/<28d)

Question 6

Hx of present preg - complx of preg ? and tests?

Answer 6

complx - bleeding/HTN, DM, anaemia, UTIs, concerns re fetal growth, any hosp admissions?
tests - USS, bloods, prenatal diagnostics??

Question 7

What is gravidity and parity?

Answer 7

grav - # of pregnancies
par - # of heads out of vagina/# of times delivered potentially viable baby (>24wks)

eg woman who is currently preg, has twins, and has had a stillbirth and a miscarriage….g+p?
g - 4 (twins = 1 preg)
p - 3+1 (+1 for miscarriage)

Question 8

What to screen for in past gynae Hx? FHx?

Answer 8

past gynae - date of last smear, any trt? prior contraception? difficulty conceiving?
FHx - twins? DM, HTN, preeclampsia, autoimmune disease, VTE disease, thrombophilia, inherited disorders

Question 9

how to present

Answer 9

this is NAME aged AGE, who is X weeks into her # pregnancy and has been admitted to hospital bc of PC (mention pain absence if no pain)

then detail Hx and sum up