Prenatal Record - National Archives and Records Administration

Instruction l\lanual for Obstetric Forms
OB-43 page 2 INITIAL PRENATAL
EXAMINATION (Continued)
Item :\umber
10-17. Pelvic examination. Record the information
required for eachitem. Measurement
of the posterior sagittal diameter
of the outlet is optional for study purposes.
18. Other pelvic abnormality. Indicate gross
asymmetry of the pelvis by marking the
appropriate box. If any other pelvic abnormality
is noted, mark "other" and
describe.
19-21. Summation. For each plane of the pelvic
bore, indicate estimation of the adequacy
by marking the appropriate box.
22. DIAGNOSTIC IMPRESSIONS. Following
completion of the initial prenatal history
and physical examination, record all
diagnostic impressions (including obstetric)
made or considered at this time.
23. Consultation sought. Record by marking
"X" in the column opposite the appropriate
diagnostic impression, to indicate
consultation is being sought.
Item Number
24. Approximate date of onset. \\'hen appropriate,
record the date of onset opposite
each diagnostic impression, with particular
emphasis on acute infectious processes
and toxemia. The date ofonset\•·ill
represent the physician's best estimate of
the date on which the disease process
began.
25-28. Editing. Report completion of the editing
procedures for the past medical history
and inital prenatal examination (forms
OB-42.and OB-43) through completio:1 of
these items.
25. Lay edit by. Initial upon completion.
26. Medical edit. Record whether editing was
accomplished with or without the aid of
the hospital chart. "Hospital chart" as
used here includes all records of medical
care during or prior to the current pregnancy
which are in the Study institution.
27, 28. Medical edit by. Provides for the sig:J.ature
and position of the medical editor.
October 1962
Reproduced at the National Archives
II.A.234
OB-43