Obstetric History Flashcards
https://geekymedics.com/obstetric-history-taking/
Nausea & Vomiting
V common
Mild - reassurance, hydration
begins at 4-7 weeks
peaks at 9-16 weeks
resolves by 20 weeks
Hyperemesis Gravidarum
Persistent vomiting, severe nausea
dehydration
electrolyte disturbance
weight loss
ketonuria
Fetal movements
Start 16-24 weeks
Primi women often not until 20+ weeks
Mother knows that is usual - so reductions should be taken seriously!
Reduced fetal movements
Assoc with adverse outcomes
Still birth
Fetal growth restriction
Placental insufficiency
Congenital malformations
- have you noticed any changes to the amount of your baby’s movement
Vaginal Bleeding
Pain
Associated trauma (domestic violence)
Fever/malaise
Ultrasound/position of placenta
Cervical screen history
Sexual history
PMH
ask about fatigue (anaemia)
ask about symptoms of hypovolaemic shock (pre-syncope/syncope)
Vaginal discharge
changes in
volume
colour (green, yellow, blood stained - suggests infection)
consistency - thick, watery
smell (fish like in BV)
Urinary symptoms
dysuria
increased freq passing
urgency - sudden need, no earlier warning
fever
Pre-eclampsia
maternal hypertension
proteinuria
oedema
fetal intrauterine growth restriction
premature birth
life threatening
symptoms:
headache - severe, frontal
swelling in hands, feet, face
epigastric tenderness
visual disturbances
reduced fetal movements
Fever
infection
UTI
cervical infections
chorioamiomitis
Fatigue
non specific
anaemia?
Weight loss
symptom of hyperemesis gravidarum
or malignancy, anorexia
Pruritis
Obstetric cholestasis
look at lec on this
Current pregnancy
Gestational age
Estimated date of delivery
Ultrasound scan
Checks for fetal anomalies
18 weeks
20 + 6 weals
& growth of fetus
placental position (is it embedded in lower 3rd of uterine cavity - if so increased risk of placenta praaevia)
Screening
Downs syndrome
Rhesus status
presence of antibodies
Hep Bm HIV, syphillis
