Obstetrics history Flashcards
When would you take an obstetrics history?
When someone is pregnant
What is meant by:
Gestational age
Gravidity
Parity
Gestational age- how long they were pregnant for
Gravidity- number of pregnancies
Parity- How many births (dead or alive)
What key symptoms should be asked about (8)?
Nausea and vomiting Reduced fetal movements Vaginal bleeding Abdominal pain Vaginal discharge Headache/visual disturbance/ epigastric pain Pruitis Urinary symptoms
When do fetal movements start in pregnancy?
What can reduced fetal movements indicate in a pregnant woman?
Fetal movements start at around 16-20 weeks, closer to 20 in those who are pregnant for the first time
May indicate stillbirth, fetal growth restriction, placental insufficiency congenital malformations
What can vaginal bleeding indicate in a pregnant woman?
Has a very wide differential diagnosis. What is key is to do a number of investigations to illicit the source of the problem.
Associated trauma/pain Fever/malaise USS Cervical screening history Sexual history
What can vaginal discharge indicate in a pregnant woman?
What do you want to know about discharge?
All healthy women will have some sort of degree of regular vaginal discharge so it is important to distinguish between normal and abnormal discharge
Volume
Colour- green,yellow or blood stained= infection
Consistency
Smell (trout-bacterial vaginosis)
What can Headache/epigastric pain/visual disturbance indicate in a pregnant woman?
What other signs may come along?
Pre-eclampsia! Do not miss! Key signs-
Headache- severe and frontal
Swelling in hands, feet and face
Pain in the upper part of the abdomen (epigastric tenderness)
Visual disturbance (blurring of vision and flashing lights)
Reduced fetal movements
What can urinary symptoms indicate in a pregnant woman?
Possibly UTI which may lead to fetal death, developmental delay and cerebral palsy
Dysuria- pain when passing urine
Frequency- increased frequency of passing urine
Urgency- a sudden need to pass urine with no earlier warning
Fever
What can nausea and vomiting indicate in a pregnant woman?
Morning sickness- 4th-20th weeks of pregnancy
Can lead to hypermesis gravidarum, persistent and severe vomiting leading to dehydration and electrolyte disturbance, weight loss and ketonuria
What is important to determine in previous pregancies?
Gestation/Birth weight
Mode of delivery
Complications
What should you ask about cervical smears?
Confirm the date of the last cervical screening test
Confirm the result
Any follow- ups?
What previous gynaecological diagnoses and treatments are important to know?
Sexual transmitted infections
Endometriosis
Bartholin’s cyst
Malignancy
