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    Obstetric History

    Uploaded by

    nn580778
    Document contains several obstetric history question

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Obstetric History

    Uploaded by

    nn580778
    1 views4 pages
    Document contains several obstetric history question

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Document contains several obstetric history question

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views4 pages

    Obstetric History

    Uploaded by

    nn580778
    Document contains several obstetric history question

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 4

    Obstetric History

    General Patient Information (Demographic Details)


    Patient Details Her Husband
    Name Name
    Occupation Occupation
    Age Age
    Blood Group & Rh Blood Group & Rh

    Religion Religion
    Address DOE
    DOA Next of kin

    Gravida (All NOP) Para (NOP After 24 weeks) Abortion (NOP before 24 weeks)

    Notes

    Last Menstrual Period (LMP)


    Estimation Data of Delivery (EDD)
    Weeks of Gestation
    Last U/S

    Chief Complaint & Duration


    ( ) for ( )duration before admitted to Hospital.

    History of Present Illness (HPI)


    Review of Other Systems
    Cardiovascular System Respiratory System Gastrointestinal System
    Chest Pain Cough Abdominal Pain
    Palpitation Sputum (Color?) Anorexia
    Dyspnea (SOB) Wheezing Nausea/Vomiting
    Cyanosis Rhinorrhea Diarrhea
    Ankle swelling Hemoptysis Constipation
    Claudication Stridor Hematemesis
    Anemia Hoarseness Hematochezia
    Oedema Other Melena
    Musculoskeletal System General Sign & Symptom Dysphagia
    Joint Pain Fever Odynophagia
    Joint Swelling Sweating Dyspepsia
    Muscle Weakness Appetite Polyphagia
    Bone Pain Wight loss/gain Heart burn
    Genitourinary System Central Nervous System Integumentary System
    Loin Pain Headache Rash
    Frequency Weakness Itching
    Hematuria Dizziness Hirsutism
    Proteinuria Vertigo Hematological System
    Dysuria Coma (LOC) Bleeding tendency
    Polyuria Fit (Seizure) ITP
    Oliguria Nasal Regurgitation Endocrine system
    Anuria Paraplegia Hot/Cold
    Urine Retention Dysphasia intolerance

    History of Present Pregnancy


    1st Trimester (1-13 Weeks) 2nd Trimester (14-28 Weeks) 3rd Trimester (29-40 Weeks)
    Appetite Wight Gain Headache
    Nausea Nausea Anemia
    Backache Quicking Chest Pain
    Dysuria Polyuria Palpitation
    Urine Color Vomiting Dyspnea (SOB)
    Constipation Oedema Leg Oedema
    Vaginal Bleeding Tachycardia Vaginal Bleeding
    Other Paresthesia Other

    Past Obstetric History


    Date of Marriage Date of 1st pregnancy

    Any Period of Infertility (from marriage to 1st Pregnancy)


    History of each Pregnancy
    Ask about 1st Pregnancy 2nd Pregnancy 3rd Pregnancy 4th Pregnancy 5th Pregnancy
    Normal Pregnancy or Not?
    Bleeding
    Infection
    Vomiting
    DM
    HTN
    Regular Antenatal care or Not?
    Duration of Pregnancy
    Onset of Delivery
    (Spontaneous, induced by C/S)
    Past Surgical Complications
    Location of Delivery
    Data of Delivery
    Crying Time
    Baby had start Brest feeding
    Normal Baby or Not?
    Gender, Wight of Baby
    History of Contraception

    Menstrual Cycle History


    Date of 1st Cycle Regular Cycle or Not?

    Length of Cycle Painful or Not?

    Past Medical History


    Chronic Disease Past Admission to
    DM CCU
    HTN ICU
    Peptic Ulcer Outpatient Clinic
    Other Other

    Past Surgical History


    Surgical Operation & Date Last Dental Procedure & Date

    Last Blood Transfusion & Date


    Drug History
    Drug Hx

    Chronic Drugs Supplements

    Drugs Allergy Food Allergy

    Family History
    Family Hx
    Family Chronic Family Genetic
    Disease Disease
    Hx of Twin Relatives or Not?
    Other & Notes

    Social-economic History
    Social-economic Hx
    Smoking (Herself or Passive) Water Supply
    Alcohol Economic State
    Crowded House or Not? Rural or Urban Place?
    Contact with Animal or Not? Travel History

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