Prenatal Record - National Archives and Records Administration

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REPRODUCTIVE HISTORY {Can't.) Item #10. "Type of Delivery" OB-2 l/59 Make sure that the gravida understands the terms you use in asking this question. Choose the correct term and write the abbreviation in the box. Abbreviate vaginal as "VAG", Cesarean as "CES", Vertex as "VTX", Breech as "BR", Operative as "OP", and Spontaneous as "SPON". The term "Operative delivery" as commonly used includes procedures that the gravida will not necessarily regard as operative. To guarantee uniformity, ask the gravida "were forceps used.when this child was born?" If the answer is yes, write "OP," if no write "SPON," if unknown write "UNK". Item #11. "Birth \tleight" Record this to the nearest ounce. If there is doubt about the exact weight, select ~he most probable weight and record it in pounds and ounces. Item #12. "Place of Birth" If at home, write "home". If in a hospital, name the hospitaL In all cases give the location - city or town and when necessary, state or country. Item #13. "Abnormalities at Birth" For pregnancies of less than 20 weeks gestation write "NA" in this space and go on to item #14. For all other children live or stillborn, ask the patient if there was any thing about the child that "wasn't formed right", and record her answer. For a live born child, ask if it had any difriculty in breathing, need for blood transfusion, etc. Item #14. "Name of Father" Record the father's (not necessarily the husband's) first name. Item #15. "Race of Father" Record as W, N, OR, PR, or "Other" 1 as on .t\R-1. Item #16. "Date of Death" If the child was stillborn, or i~ the pregnancy terminated with a miscarriage, or if the child is now alive, write "NA" in the box. If the child was born alive but is now dead, record the exact date if this is known. Item #17. "Place of Death" Write "NA" in this box if it appears ror item #16. Otherwise, record the city and if necessary, state in which the death occurred. February 1959 (For Forms in Use April 1961) II.A.34 OB-2 Reproduced at the National Archives
REPRODUCTIVE HISTORY (Con•t.) C3-2 l/59 Item #18, "Cause of Death 11 If "NA 11 appears in items #16 and #17 1 write it here also. Otherwise, ask ~he gravida what caused the child's death. If it was an accident of any sort, record "accident 11 • For other cases attempt to determine the specific cause. February 1959 (For Forms in Use April 1961) II.A.35 OB-2 Reproduced at the National Archives
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NINCDS COLLABORATIVE PERINATAL PROJ
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NINCDS COLLABORATIVE PERINATAL PROJ
Page 5 and 6: INTRODUCTION DOCUMENT OBJECTIVES AN
Page 7 and 8: Forms The first forms used in the s
Page 9 and 10: Reproduced at the National Archives
Page 11 and 12: selection. A n1n was used for patie
Page 13 and 14: , researcher is more likely to look
Page 15 and 16: TABLE 3. Abbreviations for Person,
Page 17 and 18: TABLE 4. Definition of Person, Time
Page 19 and 20: TABLE 4. Definition of Person, Time
Page 21 and 22: CONTENTS AR-1/0B-1 OB-2 OB-3 OB
Page 23 and 24: AR-1 Obstetrical Administrative Rec
Page 29 and 30: DEFINITION OF CODES {Continued) FOR
Page 31 and 32: ... 1;:: I ~ .J.I'40JI.!9d jl5 !
Page 33 and 34: ADMINISTRATIVE RECORD MANUAL PHS-30
Page 35 and 36: ADMI!liSTRATIVE RECORD ;fl.A.TI.TUA
Page 37 and 38: -· IID'~7-- '·"'-- ':!e- ~ l·-~
Page 39 and 40: OB-1: OBSTETRICAL· ADMINISTRATIVE
Page 41 and 42: Par. 3 10 - Religion. Record as Cat
Page 43 and 44: OB-2 Reproductive History Form OB-2
Page 47 and 48: COLIII:•IOoa-& ,.., REPRODUCTIVE
Page 51 and 52: DEFTIITTION OF CODES (Continued) FI
Page 53 and 54: 1 Reproduced at the National Archiv
Page 55: R~PRODUCTI\~ HISTORY (Con't.) C3-2
Page 59 and 60: OB-3 History Since Last Menstrual P
Page 63 and 64: eoL"-aooa.a ACV. n-et • HISTORY S
Page 67 and 68: DEFINITION OF CODES (Continued) FOR
Page 69 and 70: DEFJNITION OF CODES (Continued) FOR
Page 71 and 72: "' 1: : ~~ :; "':J. !~ ~ ~ :~ ~ ; :
Page 73 and 74: HISTORY SINCE LAST 1-ENSTRUAL PERIO
Page 75 and 76: HISTORY SINCE ~T MENSTRQ~ P~RIOD {C
Page 77 and 78: OB-4 Gynecological History Form OB-
Page 81 and 82: COL.,.-aaaa-4 RIEV. tt-11 • GYNEC
Page 83 and 84: DEFINITION OF CODES GYNECOLOGICAL H
Page 85 and 86: DEFINITION OF CODES (Continued) FIE
Page 87 and 88: '? I~ 1: :1\ j; t:: t; ....J 7 ,.
Page 89 and 90: GY1~F..COLOGICAL HISTORY (Con't.) O
Page 91 and 92: 08-5 Recent Medical History Form 08
Page 99 and 100: DEFINITION OF CODES RECENT MEDICAL
Page 101 and 102: DEl!'INITION OF CODES (Continued) F
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ILL..'1ESS OR DISABILITY CODES (Con
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Reproduced at the National Archives
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RECENT MEDICAL HISTORY (Con 1 t) OB
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OB-6 Past Medical History Form OB-6
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z PAST MEDICAL HISTORY (Interviewer
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DEF'll'UTION OF CODES PAST MEDICAL
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DEF'INli'ION OF CODES (Continued) F
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DEFINITION OF CODES (Continued) u.
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DEFINITION OF CODES (Continued) FOO
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PAST HEDICAL HISTORY (Con't) Item 1
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HISTORY TAKEN BY PAST MEDICAL HISTO
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OB-7 Infectious Disease and System
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COLIII.•I00 ..7 ,... INFECTIOUS D
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C:OLft-IOOa-7 1··· INFECTIOUS DI
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DEFINITION OF CODES nlFECTIOO'S DIS
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DEl''ll'IITION OF C:JDES ( Conti:::
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i i :a :: ·• 1: !: ! I! ::
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l!:i i!;T!IJIJ;: IIJ;;:..f,;:l·: .
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INF~TIOUS DIS~S~ ;~D SYSTEM REVIEW
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OB-8 Repeat Prenatal History Form O
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I. ftATIIMT IDfNTIPICATIOM REPEAT P
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DEFINITION OF CODES (Continued) FOR
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DEFINITION OF CODES (Continued) FIE
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~ :: : j: ~ : I~ =r ; Ia ~ ~ !~ ;
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,;.-~ 1•1. 1J;,.... - ~ .. u;W'o'
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OB-9 Prenatal Record Form OB-9, Pre
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C:OL.II.·- I•It NU\E IHOSPITAL
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•• 'HISTORY NO. diRIRXL IXXMI l
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~~J2ITTIGN OF CODES (Co~~i~ued) FCa
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DEFINITION OF CODES (Continued) FOF
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DEF~~ION OF CODES (Continued) PELVI
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DEFTIHTION OF CODES (Continued) FQR
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ZEFT1ITTIO:i OF CODES (Con"'c:..!!U
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DEFINITION OF CODES ( Con~inued) FC
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:t , I~ I ~ It II! I~ ::: .. ~ .. ~
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!:: llil\41.0 ~ ~~ ~'~"'~ -N OB-9 -
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PRENATAL RECORD (Con 1 t) PRESENT P
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PRENATAL RECORD (Con 't) complete a
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PRENATAL RECORD (Can't) EVALUATION
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PRENATAL RECORD (Con't) GENERAL IDl
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OB-42 Past Medical History Form OB-
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-· eoL"-aooa-..a 08-42 PAST MEDICA
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Instruction Manual for Obstetric Fo
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OB-43 Initial Prenatal Examination
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COL ..-3008-41 UIIYe 10.U) 1. PATIE
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DEFINITION OF CODES miTIAL PRENATAL
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DEFINITION OF CODES (Continued) FOB
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DEF'INITION OF CODES (Continued) FO
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I ,rnrn:r s YIN.Ct:l S6¥:;~rn I
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I, I'ATIENT IDENTI,.ICATIDN OB-43 I
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OB-10 Return Visit and Laboratory R
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DEFTIUTION OF CODES (Continued) FOR
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DEFINITION OF CODES (Continued) FOB
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4/16/61 OB-10 RETURN VISIT AND LAB
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~"........ ,... ~,_~.a., RETURN VIS
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OB-44 Prenatal Observations Form OB
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..... C:Ol..llt-IOOa-44 1. PATIENT
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:FDRMS 03-10 DEFINITION OF CODES (C
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DEFINITION OF CODES (Continued) ~·
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Instructional Manual for Obstetric
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OB-45 Laboratory Record Form OB-45
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DEFllUTION OF CODES LABJRATORY RECO
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DEFJNITION OF CODES (continued) FIE
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DEFINITION OF CODES (continued) FOR
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DEFINITIDN OF CODES (continued) FOR
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DEFTIUTION OF CODES (continued) FOR
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DEFINITION OF CODES (continued) FIE
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DEFINITION OF CODES (continuted) FI
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DEFTIHTION OF CODES (continued) FIE
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DEFTIUTION OF CODES (continued) FIE
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OB-11 Record of Current Pregnancy F
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CO~A·3C03·11 lltEV. '7·58 I. PAT
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RECORD OF CURRENT PREGNANCY (For Fo
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,... RECORD OF CURRENT PREGNANCY IN
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OB-46 Physician•s Clinic Record,
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COLR-1001-4e 4-a I. PATIENT IDENTII
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Instruction :\l:J.nual for Obstetri
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OB-12 Summary of Hospitalization fo
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SUMMARY OF HOSPITALIZATION FOR ANY
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SUMMARY OF HOSPITALIZATION FOR ANY
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':.::-•••suMMARY OF HOSPITALI
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OB-47 Summary of Antepartum Hospita
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· COLIII-IOOa..7 (CHANGIED 2-8a)
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OB-15 Drugs in Pregnancy Form OB-15
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PH S.300S.18 ..... PATIENT IDENTIFI
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.... PMS•3003•18 PATIENT IDENTI
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PHI·IOOI .. 1B P"TIENT IOENTIFIC"T
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PATI~NT IDENTIFICATION OB-15 DRUGS
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..... PHS .. 3003 ... 11 PATII!NT I
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DEFINITION OF CODES DRUGS lN PREGN
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Drugs in Pregnancy (08-15) Blank 0
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Drugs in Pregnancy (cont.} 2128 Par
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Orugs in Pregnancy (cont.) 4256 Hyo
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. Drugs in Pregnancy (cont.) 7154 S
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1 Drugs in Pregnancy (cont.) 7482 O
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Drugs in Pregnancy (cont.) 9169 917
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Drugs in Pregnancy (cont.) 9949 995
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Prenatal Record - National Archives and Records Administration

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