Prenatal Record - National Archives and Records Administration

Instructions, OB-10 (cont.)
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18~1.9. FHR. Record the fetal heart rate in item 17 and indicate the quadrant
of the mother's abdomen in which the fetal heart is located in item
19.
20-41. I.aborgtory Elcaminatigns. Record the date the specimen is taken and
when the result has been returned, record the result in the appropriate
space. When blood is drawn for virology study, record the
date (month, day and yeEr) the specimen is obtained. If diagnostic
X-rays are obtained while the patient is receiving prenatal care,
record the date, indicate the reason, and describe the findings
briefly. If the patient is seen more than eight times during the
prenatal course,,a second Form OB-10 should be used.
The following are the prenatal laboratory requirements:
Procedure
Schedule
1. Urinalysis (Complete) At initial visit
2. Urinalysis (Albwnin and Sugar) At each return visit
3. Microhematocrit reconunended (At initial visit
(Cyanmethemoglobin acceptable) (At about 32 weeks of gestation
4· Serology Once during pregnancy
5. ABO Type and RH Type Once during pregnancy
6. Indirect Coombs Once during pregnancy
(if D and Du nesative)
It is recommended tbat abnormal or suspicious laboratory findings
be followed up with additional laboratory work as indicated and
the results ~e reported on OB-10.
This form should be forwarded after the termination of pregnancy
and after the form has been edited.
Reproduced at the National Archives
II.A.256
OB-10