APPROACH TO AN APPROACH TO AN OBSTETRIC PATIENTOBSTETRIC PATIENT

HISTORYHISTORY

HISTORY TAKING IS AN ART – HISTORY TAKING IS AN ART – ENQUIRE REGARDING THE WELL- ENQUIRE REGARDING THE WELL- BEING OF MOTHER AS WELL AS BEING OF MOTHER AS WELL AS FETUSFETUS

HISTROY OF PAST PREGENCY – MAY HISTROY OF PAST PREGENCY – MAY ALTER THE OUTCOME OF PRESENT ALTER THE OUTCOME OF PRESENT PREGNANCYPREGNANCY

PARTICULARS OF THE PARTICULARS OF THE PATIENTSPATIENTS

NAMENAME AGEAGE ADDRESSADDRESS MARITAL STATUSMARITAL STATUS DATE OF ADMISSIONDATE OF ADMISSION DATE OF EXAMINATIONDATE OF EXAMINATION GRAVIDA & PARITYGRAVIDA & PARITY

CHIEF COMPLAINTSCHIEF COMPLAINTS

CHIEF COMPLAINTS WITH CHIEF COMPLAINTS WITH DURATION IN CHRONOLOGICAL DURATION IN CHRONOLOGICAL ORDER IN PATIENTS LANGUAGEORDER IN PATIENTS LANGUAGE

MAY PRESENT WITH :MAY PRESENT WITH :

1.1. AMENORRHOEAAMENORRHOEA

2.2. SYMPTOMS RELATED TO SYMPTOMS RELATED TO PREGNANCYPREGNANCY

3.3. ANKLE OEDEMAANKLE OEDEMA

CHIEF COMPLAINTSCHIEF COMPLAINTS

MAY PRESENT WITH :MAY PRESENT WITH :

4.4. PAIN IN THE ABDOMENPAIN IN THE ABDOMEN

5.5. BACKACHEBACKACHE

6.6. BLEEDING IN PREGNANCY: EARLY / LATEBLEEDING IN PREGNANCY: EARLY / LATE

7.7. LESS FETAL MOVEMENTLESS FETAL MOVEMENT

8.8. UNDUE ENLARGEMENT OF THE ABDOMENUNDUE ENLARGEMENT OF THE ABDOMEN

9.9. VAGINAL DISCHARGEVAGINAL DISCHARGE

HISTORY OF PRESENT HISTORY OF PRESENT ILLNESSILLNESS

1.1. AMENORRHOEA: AMENORRHOEA:

Expressed in weeks, Calculated from Expressed in weeks, Calculated from LMPLMP

Diagnosis of pregnancy confirmed???Diagnosis of pregnancy confirmed???

2.2. SYMPTOMS RELATED TO PREGNANCY: SYMPTOMS RELATED TO PREGNANCY:NAUSEA & VOMITINGFREQUENCY OF MICTURATION

HISTORY OF PRESENT HISTORY OF PRESENT ILLNESSILLNESS

2.2. SYMPTOMS RELATED TO PREGNANCY: SYMPTOMS RELATED TO PREGNANCY:CONSTIPATIONHEAVINESS IN THE BREASTRISE OF TEMPERATURE

3. ANKLE OEDEMA:ANKLE OEDEMA:PRESSURE DUE TO GRAVID UTERUS? HTN, ??? Protein Urea

HISTORY OF PRESENT HISTORY OF PRESENT ILLNESSILLNESS

4.4. PAIN ABDOMEN: PAIN ABDOMEN:LABOUR PAINABRUPTIO PLACENTAEPRE-ECLAMPSIA TOXEMIADEGENERATION OF MYOMAACUTE URINARY RETENSIONTORSION OF OVARIAN CYST

ACUTE CHOLECYSTITISACUTE CHOLECYSTITIS

HISTORY OF PRESENT HISTORY OF PRESENT ILLNESSILLNESS

5.5.BACKACHE:BACKACHE:INCREASE IN BODY WEIGHTHYPER EXTENSION OF SPINELAXITY OF JOINTS IN PELVIS AND SPINE

6. VAGINAL BLEEDING:6. VAGINAL BLEEDING:Implantation Haemorrhage, Abortion, Ectopic Implantation Haemorrhage, Abortion, Ectopic Pregnancy, H.mole, Placenta PreviaPregnancy, H.mole, Placenta PreviaAbruptio Placenta Abruptio Placenta

HISTORY OF PRESENT HISTORY OF PRESENT ILLNESSILLNESS

7.7.LESS FETAL MOVEMENT: LESS FETAL MOVEMENT: 10/ 12 hrs10/ 12 hrsPRIMI: 18 weeksMULTI: 16 weeks

8..UNDUE ENLARGEMENT OF THE UNDUE ENLARGEMENT OF THE ABDOMEN:ABDOMEN:MULTIPLE PREGNANCY, HYDRAMNIOS, ABRUPTIO PLACENTA, MACROSOMIA, MISTAKEN DATE

HISTORY OF PRESENT HISTORY OF PRESENT ILLNESSILLNESS

9.9.VAGINAL DISCHARGE:VAGINAL DISCHARGE:

RUPTURE OF MEMBRANEPHYSIOLOGICAL LEUCORRHOEACANDIDIASISCERVICITIS

10. HISTORY OF TT/ IRON+ CA HISTORY OF TT/ IRON+ CA SUPPLIMENTSUPPLIMENT

HISTORY OF PAST ILLNESSHISTORY OF PAST ILLNESS

PAST MEDICAL HISTORYPAST MEDICAL HISTORY PAST SURGICAL HISTORYPAST SURGICAL HISTORY HTN, DM, PTB, ASTHAMAHTN, DM, PTB, ASTHAMA

FAMILY HISTORYFAMILY HISTORY

PERSONAL HISTORYPERSONAL HISTORY

DRUG HISTORYDRUG HISTORY

MENSTRUAL HISTORYMENSTRUAL HISTORY AGE OF MENARCHEAGE OF MENARCHE MENSTRUAL CYCLEMENSTRUAL CYCLE MENSTRUAL PERIODMENSTRUAL PERIOD LMPLMP DYSMENORRHOEADYSMENORRHOEA

CONTRACEPTIVE HISTORYCONTRACEPTIVE HISTORY

OBSTETRICAL HISTORYOBSTETRICAL HISTORY

S.NS.N DATDATE E OF OF DELDELIVEIVERYRY

GESGESTATTATIONIONAL AL AGAGEE

COCOMPLMPLICTIICTIONON

ANANC/ C/ DELDELIVEIVERYRY

MOMODE DE OF OF DELDELIVEIVERYRY

PUEPUERPERPERIURIUMM

CHICHILD / LD / BREBREAT AT FEDFED

IMMIMMUNIUNISATSATIONION

PHYSICAL EXAMINATIONPHYSICAL EXAMINATION

GENERAL PHYSICAL EXAMINATION :GENERAL PHYSICAL EXAMINATION :

APPEARANCEAPPEARANCE

HEIGHTHEIGHT

WEIGHTWEIGHT

PALLOR, ICTERUS, LYMPH NODES, PALLOR, ICTERUS, LYMPH NODES, CYANOSIS, CLUBBING, OEDEMA, CYANOSIS, CLUBBING, OEDEMA, DEHYDRATIONDEHYDRATION

PHYSICAL EXAMINATIONPHYSICAL EXAMINATION

VITAL SIGNS :VITAL SIGNS :

PULSEPULSE

BLOOD PRESSUREBLOOD PRESSURE

RESPIRATORY RATERESPIRATORY RATE

TEMPERATURETEMPERATURE

BREAST EXAMINATIONBREAST EXAMINATION

ABDOMINAL EXAMINATIONABDOMINAL EXAMINATION

INSPECTION:INSPECTION:

SHAPE, SCAR MARKS, VENOUS SHAPE, SCAR MARKS, VENOUS ENGORGEMENT, STRIAE ENGORGEMENT, STRIAE GRAVIDARUM, LINEA NIGRAGRAVIDARUM, LINEA NIGRA

PALPATION:PALPATION:SUPERFICIAL PALPATION: TEMPERATURE, TENDERNESS

ABDOMINAL EXAMINATIONABDOMINAL EXAMINATION

PALPATION:PALPATION:FUNDAL HEIGHT

FUNDAL GRIPLATERAL GRIPFIRST PELVIC GRIPSECOND PELVIC GRIP: PAWLIK’S GRIP

FUNDAL GRIP

LATERAL GRIP

FIRST PELVIC GRIP

SECOND PELVIC : PAWLIK’S GRIP

ABDOMINAL EXAMINATIONABDOMINAL EXAMINATION

AUSCULTATION:AUSCULTATION:

FHS: 120-160 beats / minFHS: 120-160 beats / min

FETAL TACCHYCARDIA:FETAL TACCHYCARDIA: FEVER, FEVER, DISTRESSDISTRESS

FETAL BRADYCARDIA:FETAL BRADYCARDIA: CARDIAC CARDIAC ANOMALYANOMALY

PELVIC EXAMINATIONPELVIC EXAMINATION

PRE-REQUISITS:PRE-REQUISITS:

EXPLANATIONEXPLANATION

EMPTY BLADDEREMPTY BLADDER

DORSAL POSITIONDORSAL POSITION

FULL ASEPSISFULL ASEPSIS

PELVIC EXAMINATIONPELVIC EXAMINATION

INDICATIONS:INDICATIONS:

EARLY PREGNNCY: DIAGNOSISEARLY PREGNNCY: DIAGNOSISASSESS PELVIS ADEQUACYASSESS PELVIS ADEQUACYDURING LABOUR: ASSESSMENT OF DURING LABOUR: ASSESSMENT OF PROGRSS OF LABOURPROGRSS OF LABOURCONFIRM THE PRESENTATIONCONFIRM THE PRESENTATION

INVESTIGATIONSINVESTIGATIONS DIAGNOSIS:PREGNANCY KITDIAGNOSIS:PREGNANCY KIT Hb estimationHb estimation BLOOD GROUPINGBLOOD GROUPING URINE R/M/E and URINE C/S(if signs URINE R/M/E and URINE C/S(if signs

of infection)of infection) VDRL(both partners)VDRL(both partners) BLOOD SUGARBLOOD SUGAR HIV, HEPATITISHIV, HEPATITIS USGUSG

TREATMENTTREATMENT

GENERALGENERAL OBSTETRICALOBSTETRICAL

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