OBGYN history

Question 1

Order of hx

Answer 1

PC
HPC 
Menstrual hx 
Obstetric hx 
Sexual hx
Contraception and cervical smear hx 

PMH - incl abdo surgery
DH
FH - breast, bowel, ovarian cancer
SH - drugs, alcohol, smoking

Question 2

Relevant systems review as part of HPC

Answer 2

General

Gynae - 4 Ps

• PV discharge
• PV bleeding
• Pain
• Pregnancy

GI - IBS, malignancy, appendicitis, diverticulitis

Urological - UTI, incontinence

Question 3

Menstrual hx

Answer 3

1st day of last menstrual period 
Menarche - ~12-13y or Menopause ~48-55y
Regularity and cycle length ~21-35 days 
Duration ~3-7 days 
Character - heaviness, pads/day, flooding, pain

Question 4

Obstetric hx

Answer 4

Gravida (pregnancies) & Para (>24 weeks (alive/stillborn))
Miscarriages, ectopics, TOP - stage, Rx, complications
Children (living)
- no.
- ages
- birth weight
- type of delivery
- previous problems during pregnancy / delivery

Question 5

Current pregnancy

Answer 5

1st day of LMP (gestation = date since then)
When +ve pregnancy test
Scans so far
Investigations - Rh group, Down’s, mid-trimester scan
Problems / admissions this pregnancy
Vomiting / hydration

Question 6

Sexual hx

Answer 6

Partners

• current - male or female, relationship duration
• previous partners (last 3 or all in last 6 months)
• high-risk encounters

Intercourse

• type
• pain or discomfort
• contraception used

Subfertility

Question 7

Contraception and cervical smear hx

Answer 7

Contraception - current and previous use

Cervical smear - date of last smear and results