Obstetric History Flashcards
Obstetric History
Demographics – Name, Age, Occupation, Relationship Status, G and P
o Gravida x, Para a + b where a = births and b = miscarriages or ToP
EDD
General Health, Foetal Movements if >20/40, Results of Antenatal Blood Tests, Scans
o If Postnatal, Enquire about Labour, Delivery, and Postnatal Period
• Should also include Past Obstetric History, Gynaecological History (Contraceptive use, Procedures, Smears), PMH/PSH, DH and Allergies, SH including Plans to Breastfeed, Smoking, Rec Rx, Psych Illness; FH with regards to Multiple pregnancies, DM, HTN and Genetic Diseases
EDD
EDD calculated by adding 9 months and 7 days to LMP
o Details which might affect validity of LMP include Long cycles, Irregular periods or recent use of COCP
o Dating scans between 8 to 13 weeks is more reliable than LMP
Obstetric Physical Examination: Inspection
- Apparent size of Abdominal Distention and not`e any asymmetry or Foetal movements
- Cutaneous – Linea Nigra, Striae Gravidarum, Striae Albicans, Flattening/Eversion of Umbilicus
- Superficial veins, Surgical Scars
Obstetric Physical Examination: Palpation
• Symphysis-Fundal Height – Measured in centimetres >20/40
o Normally palpable at 12/40, At Umbilicus at 20/40, At Xiphisternum 36/40
o Growth estimated to be number of weeks in centimetres ± 2-4 cm
• Estimation of number of Foetuses
• Foetal Lie – Longitudinal (Pelvic Inlet), Oblique (Iliac Fossa), Transverse (Flanks)
• Presentation – Cephalic, Breech or Other (E.g. Shoulder, Compound)
• Amniotic Fluid Volume – Estimated based on palpability of Foetal limbs
Obstetric Physical Examination: Auscultation
- Best heard over Anterior shoulder of Foetus; Doppler from around 12/40, Foetoscope from 24/40; In Breech Presentation, often heard at level of maternal umbilicus
- Rate and Rhythm determined over 1 minute
Obstetric Physical Examination: General
• BMI, BP (in Semi-recumbent 45 deg), Auscultation of Heart and Lungs, Thyroid, Breasts, Varicose Veins and Skeletal Abnormalities
