
Contents
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Obstetric history: current pregnancy Obstetric history: current pregnancy
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Current pregnancy Current pregnancy
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Obstetric history: other relevant features Obstetric history: other relevant features
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Past gynaecological/medical/surgical history Past gynaecological/medical/surgical history
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Drug and allergy history Drug and allergy history
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Family history Family history
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Social history Social history
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Obstetric physical examination Obstetric physical examination
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Abdominal examination: inspection Abdominal examination: inspection
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Abdominal examination: palpation Abdominal examination: palpation
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Auscultation of the fetal heart Auscultation of the fetal heart
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Engagement of the fetal head Engagement of the fetal head
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Paulik’s grip Paulik’s grip
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The female pelvis The female pelvis
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Pelvic muscles and ligaments Pelvic muscles and ligaments
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Diameters of the female pelvis Diameters of the female pelvis
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Plane of pelvic inlet Plane of pelvic inlet
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Plane of greatest pelvic dimensions/cavity Plane of greatest pelvic dimensions/cavity
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Plane of least pelvic dimensions/mid-pelvis (circular in shape) Plane of least pelvic dimensions/mid-pelvis (circular in shape)
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Plane of pelvic outlet Plane of pelvic outlet
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Fetal head Fetal head
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Anatomy of the fetal skull Anatomy of the fetal skull
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Regions of the fetal head Regions of the fetal head
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Diameters and presenting parts of the fetal head Diameters and presenting parts of the fetal head
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Placenta: early development Placenta: early development
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Embryological development Embryological development
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Placenta: later development Placenta: later development
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The placenta at term The placenta at term
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Fetal surface Fetal surface
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Maternal surface Maternal surface
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Umbilical cord Umbilical cord
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Placenta: circulation Placenta: circulation
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Uteroplacental circulation Uteroplacental circulation
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Arterial system Arterial system
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Venous system Venous system
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Placenta: essential functions Placenta: essential functions
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The placenta as an endocrine organ The placenta as an endocrine organ
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hCG hCG
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The placenta as a barrier The placenta as a barrier
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Physiology of pregnancy: endocrine Physiology of pregnancy: endocrine
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Endocrine changes Endocrine changes
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Progesterone ↑ throughout pregnancy Progesterone ↑ throughout pregnancy
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Oestrogens, mainly oestradiol (90%) Oestrogens, mainly oestradiol (90%)
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Human placental lactogen (hPL) Human placental lactogen (hPL)
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Physiology of pregnancy: haemodynamics Physiology of pregnancy: haemodynamics
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Plasma volume Plasma volume
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Red cell volume (or red cell mass) Red cell volume (or red cell mass)
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Total white cell count Total white cell count
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Platelets Platelets
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Clotting factors Clotting factors
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Physiology of pregnancy: cardiorespiratory Physiology of pregnancy: cardiorespiratory
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Cardiovascular changes Cardiovascular changes
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Respiratory system changes Respiratory system changes
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Physiology of pregnancy: genital tract and breast Physiology of pregnancy: genital tract and breast
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Uterus Uterus
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Cervix Cervix
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Uterine body Uterine body
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Vagina Vagina
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Breast Breast
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Physiology of pregnancy: other changes Physiology of pregnancy: other changes
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Urinary tract Urinary tract
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Alimentary system Alimentary system
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Skin Skin
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Preparing for pregnancy Preparing for pregnancy
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Exercise and stress Exercise and stress
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Supplements and lifestyle advice Supplements and lifestyle advice
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Folic acid and other vitamins Folic acid and other vitamins
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Alcohol, smoking, and recreational drugs Alcohol, smoking, and recreational drugs
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General health check General health check
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Pre-existing medical disorders Pre-existing medical disorders
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Medication Medication
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Diagnosis of pregnancy Diagnosis of pregnancy
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Clinical examination Clinical examination
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Dating of pregnancy Dating of pregnancy
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Menstrual history Menstrual history
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Dating ultrasound scan Dating ultrasound scan
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Crown–rump length Crown–rump length
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Ultrasound assessment of fetal growth Ultrasound assessment of fetal growth
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Biparietal diameter and head circumference Biparietal diameter and head circumference
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Abdominal circumference Abdominal circumference
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Femur length Femur length
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Booking visit Booking visit
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Booking visit: history Booking visit: history
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Antenatal care: planning Antenatal care: planning
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Screening for chromosomal and structural abnormalities Screening for chromosomal and structural abnormalities
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Further reading Further reading
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Antenatal care: routine blood tests Antenatal care: routine blood tests
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Routine blood tests Routine blood tests
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Full blood count (FBC) Full blood count (FBC)
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Blood grouping and antibody screen Blood grouping and antibody screen
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Rubella screen Rubella screen
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Syphilis screen Syphilis screen
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Hepatitis B screen Hepatitis B screen
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HIV screen HIV screen
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Antenatal care: specific blood tests Antenatal care: specific blood tests
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Haemoglobin electrophoresis Haemoglobin electrophoresis
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Miscellaneous tests Miscellaneous tests
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Screening for gestational diabetes Screening for gestational diabetes
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Risk factors for gestational diabetes Risk factors for gestational diabetes
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Antenatal care: preparing for delivery Antenatal care: preparing for delivery
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Cite
Extract
Obstetric history: current pregnancy
Obstetric history taking has many features in common with most other sections of medicine, along with certain areas specific to the specialty. The basic framework can be easily learned; however, competence requires good clinical knowledge and a lot of practice. As obstetrics often requires intimate examination and discussion of sensitive information, it is important to ensure privacy, and to demonstrate respect and confidentiality. It is important to offer a health professional as a chaperone. Translation may be required and it is best to have an official translator. The family, especially the husband, translating may not divulge or may distort certain information. It is also important to ask about domestic violence when the mother is alone and offer help if appropriate.
A carefully obtained history taken in a logical sequence avoids inadvertent omission of important details, and guides the examination to follow.
Current pregnancy
Much of this information will be contained in the patient’s ‘hand-held’ notes:
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