Obstetrics Manual for Merrygold Hospitals - State Innovations in ...

Unit 1.2 Clinical assessment (History taking, physical
examination and routine investigation)
Learning Objectives
• Know the important points to be asked while collecting history to a pregnant
woman.
• Understand and be able to perform physical examination on a pregnant
woman.
• Understand the routine investigations to be done during antenatal period.
1.2.1 History Taking
‣ Date of Last Menstrual Period:
• Ask for date of 1 st day of the last menstrual period (LMP)
• Calculate the Expected Date of Delivery (EDD) = LMP + 9months and 7
days. This calculation is based on the assumption that the menstrual cycle
was regular and it was a 28-30 days’ cycle. If the cycle varies, EDD will
vary accordingly
• Calculate Period of Gestation in weeks: Period of gestation is to be
expressed in terms of completed weeks. A fraction of more than 3 days is
to be considered as completed week.
‣ Age of the woman
‣ Duration of marriage
‣ Order of the pregnancy
‣ Gravida (GPAL- Gravida, Para, Abortion, Living children)
‣ Last child birth/ Last abortion
‣ History of present pregnancy
‣ Complaints during present pregnancy (to be asked during each visit):
• Excessive vomiting
• fever
• Palpitations, easy fatigability and breathlessness at rest
• Puffiness of the face
• Headache or blurring of vision
• Passing smaller amounts of urine
• Vaginal bleeding or Leaking of watery fluid per vaginam(P/V)
• Pain abdomen at any stage of pregnancy
• Decreased or absent foetal movements
‣ History of problems during the previous pregnancy/ delivery (Obstetric
History)-
• Abortion(s) or Premature birth(s),
• Twins or multiple pregnancies
• Stillbirths(s) or neonatal loss
• Hypertensive disorder of pregnancies(if don’t know, ask for a history of
convulsion in previous pregnancies)
• Duration of labor
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