Documentos de Académico
Documentos de Profesional
Documentos de Cultura
Name
Age/ D.O.B
Marital Status (Duration)
Hometown
Gravidity
Parity
LRMP (are they regular? Long or short in duration?) and POA (calculate
from LRMP to now)
EDD (from LRMP and from USS)
Pc: Eg) Abdominal pain, GDM, delivery, as requested for CS, for Ix, due to HTN.
HxPc:
Current Pregnancy:
During booking visit, did patient have FBC, ABO, FBG done? Was BMI
checked? Any murmurs, pallor etc checked?
Dating scan done? At which POA?
Any complications or complaints?
Was patient hospitalised?
How many past pregnancies? In chronological order mention: the MOD (if
CS, why?), if it was term or pre-term, induced or not, if the baby was
healthy (then and now), and the birth weight.
Current age of child/ children
Any complications? (Pregnancy induced hypertension (PIH), Gestational
Diabetes Mellitus (GDM), Early onset pre-eclampsia, placental abruption,
Foetal growth restriction (FGR) or unexplained stillbirth)
Gap between pregnancies?
Any miscarriages? Recurrent or one-off? Cause (if known)? Ectopic
pregnancies?
Any complications for mother post-partum?
Breastfeeding?
Contraceptive use? Any changes in contraception and if so, why?
SI:
PMHx: DM, DL, HTN, thyroid, epilepsy, cardiac/renal/hepatic problems, bronchial
asthma, haematological diseases.
Psychiatric Hx: post-partum depression, depression unrelated to pregnancy,
major psych. illness.
Drug Hx:
Allergies:
PSHx:
Family Hx: Multiple (twin, triplet) pregnancies, congenital conditions, inherited
conditions
Social Hx: Family support, socio-economic status, nearest hospital, diet (?)