Prenatal Record - National Archives and Records Administration

Instruction :\Ianual for Obstetric Forms
OB-43 ,age 1 INITIAL PRENATAL
EXAMINATION (Continued)
Item Number
20. Thyroid and thyroid function. Report here
physical signs of thyroid dysfunction, e.g.
hypo- or hyperthyroidism, by marking the
appropriate box and describing in the avail­
able space. This includes findings in other
systems (e.g., eyes, skin, neurological).
Do n o t mark "Signs ofthyroid dysfunction''
when the thyroid gland is abnormal only
to palpation.
21. Breasts. If an inflammatory mass is
present, mark both boxes, "mass" and
"inflammation."
22. Lungs. Report findings of physical exami­
nation. Record markedly reduced vital
capacity under "other," and describe.
23. Heart. If any findings lead to consideration
of organic heart disease, always mark the box
sa labeled, in addition to marking any ather
apprapri ate boxes. If a murmur is con­
sidered physiological for pregnancy, or
Item Number
functional, mark "murmur"and describe
as "normal for pregnancy," etc.
24. Extremities. Record all findings pertaining
to extremities here, ather than edema
or scars, which are reported in items #16
and 15 respectively.
25. Neurological. Mark all appropriate boxes.
N e u r o I o g i c a I disorders should include
muscular abnormalities secondarv to
neurological involvement. ­
26. Funduscopic. A funduscopic examir::otion
is optional.
27. Other