Obstetric History Flashcards
What is Naegele’s rule for calculating estimated due date?
LMP + 9 months + 7 days for regular cycles
Irregular cycles - CRL on scan
What is the different between gravidity and parity?
- Gravidity - number of pregnancies that a woman has had to any stage
- Parity - number of pregnancies that resulted in delivery beyond 24/40
What is it important to ask at every antenatal visit?
- Abdominal pain
- Discharge
- PV bleeding
- Foetal movements past 20/40
- Breathlessness, headache, visual problems, fevers
- Mood
What are the things to consider in the first trimester in a history?
- How was pregnancy confirmed?
- Planned/spontaneous/IVF?
- Symptoms of pregnancy
- Booking appointment - type of antenatal care
- Rh group?
What are the things to consider in the second trimester in a history?
- Prenatal diagnosis, amniocentesis/CVS?
- Anomaly scan
- Placental position
- Foetal movements if >20/40
What are the things to consider in the third trimester in a history?
- Foetal movements
2. Birth plan
What is included in a focused obstetric history?
- All previous pregnancies including miscarriage, TOP, stillbirth.
- Antenatal problems - PET, date and place of delivery
- Labour - mode and gestation of delivery, delivery complications
- Postnatal period and neonatal life
What is included in a focused gynaecological history during an obstetrics appointment?
- Contraception pre-conception
- Difficulties with conception
- Smear history
- Previous gynaecological problems
Which previous conditions are important to ask about in an obstetric history?
Asthma, diabetes mellitus, HTN, heart disease, epilepsy, psychiatric history.
What features should you consider during an antenatal examination?
- Pallor, oedema, BP, urine
- Inspect - C-section scar, linea nigra, striae gravidarum, everted umbilicus, foetal movements.
- Palpate - SFH, lie, presentation, engagement.
- Doppler auscultation of anterior shoulder for foetal heart.
