APPROACH TO AN OBSTETRIC PATIENT

HISTORY HISTORY TAKING IS AN ART – ENQUIRE REGARDING THE WELL- BEING OF MOTHER AS WELL AS FETUS HISTORY TAKING IS AN ART – ENQUIRE REGARDING THE WELL- BEING OF MOTHER AS WELL AS FETUS HISTROY OF PAST PREGENCY – MAY ALTER THE OUTCOME OF PRESENT PREGNANCY HISTROY OF PAST PREGENCY – MAY ALTER THE OUTCOME OF PRESENT PREGNANCY

PARTICULARS OF THE PATIENTS NAME NAME AGE AGE ADDRESS ADDRESS MARITAL STATUS MARITAL STATUS DATE OF ADMISSION DATE OF ADMISSION DATE OF EXAMINATION DATE OF EXAMINATION GRAVIDA & PARITY GRAVIDA & PARITY

CHIEF COMPLAINTS CHIEF COMPLAINTS WITH DURATION IN CHRONOLOGICAL ORDER IN PATIENTS LANGUAGE CHIEF COMPLAINTS WITH DURATION IN CHRONOLOGICAL ORDER IN PATIENTS LANGUAGE MAY PRESENT WITH : MAY PRESENT WITH : 1.AMENORRHOEA 2.SYMPTOMS RELATED TO PREGNANCY 3.ANKLE OEDEMA

CHIEF COMPLAINTS MAY PRESENT WITH : MAY PRESENT WITH : 4.PAIN IN THE ABDOMEN 5.BACKACHE 6.BLEEDING IN PREGNANCY: EARLY / LATE 7.LESS FETAL MOVEMENT 8.UNDUE ENLARGEMENT OF THE ABDOMEN 9.VAGINAL DISCHARGE

HISTORY OF PRESENT ILLNESS 1. AMENORRHOEA: Expressed in weeks, Calculated from LMP Diagnosis of pregnancy confirmed??? 2. SYMPTOMS RELATED TO PREGNANCY: NAUSEA & VOMITING FREQUENCY OF MICTURATION

HISTORY OF PRESENT ILLNESS 2. SYMPTOMS RELATED TO PREGNANCY: CONSTIPATION HEAVINESS IN THE BREAST RISE OF TEMPERATURE ANKLE OEDEMA: 3. ANKLE OEDEMA: PRESSURE DUE TO GRAVID UTERUS ? HTN, ??? Protein Urea

HISTORY OF PRESENT ILLNESS 4. PAIN ABDOMEN: LABOUR PAIN ABRUPTIO PLACENTAE PRE-ECLAMPSIA TOXEMIA DEGENERATION OF MYOMA ACUTE URINARY RETENSION TORSION OF OVARIAN CYST ACUTE CHOLECYSTITIS

HISTORY OF PRESENT ILLNESS 5.BACKACHE: INCREASE IN BODY WEIGHT HYPER EXTENSION OF SPINE LAXITY OF JOINTS IN PELVIS AND SPINE 6. VAGINAL BLEEDING: Implantation Haemorrhage, Abortion, Ectopic Pregnancy, H.mole, Placenta Previa Abruptio Placenta

HISTORY OF PRESENT ILLNESS 7. LESS FETAL MOVEMENT: 10/ 12 hrs PRIMI: 18 weeks MULTI: 16 weeks.UNDUE ENLARGEMENT OF THE ABDOMEN: 8.UNDUE ENLARGEMENT OF THE ABDOMEN: MULTIPLE PREGNANCY, HYDRAMNIOS, ABRUPTIO PLACENTA, MACROSOMIA, MISTAKEN DATE

HISTORY OF PRESENT ILLNESS 9. VAGINAL DISCHARGE: RUPTURE OF MEMBRANE PHYSIOLOGICAL LEUCORRHOEA CANDIDIASIS CERVICITIS HISTORY OF TT/ IRON+ CA SUPPLIMENT 10. HISTORY OF TT/ IRON+ CA SUPPLIMENT

HISTORY OF PAST ILLNESS PAST MEDICAL HISTORY PAST MEDICAL HISTORY PAST SURGICAL HISTORY PAST SURGICAL HISTORY HTN, DM, PTB, ASTHAMA HTN, DM, PTB, ASTHAMA FAMILY HISTORY PERSONAL HISTORY DRUG HISTORY

MENSTRUAL HISTORY AGE OF MENARCHE AGE OF MENARCHE MENSTRUAL CYCLE MENSTRUAL CYCLE MENSTRUAL PERIOD MENSTRUAL PERIOD LMP LMP DYSMENORRHOEA DYSMENORRHOEA CONTRACEPTIVE HISTORY

OBSTETRICAL HISTORY S.N DAT E OF DEL IVE RY GES TATI ONA L AGE CO MPL ICTI ON ANC / DEL IVE RY MO DE OF DEL IVE RY PUE RPE RIU M CHI LD / BRE AT FED IMM UNI SATI ON

PHYSICAL EXAMINATION GENERAL PHYSICAL EXAMINATION : GENERAL PHYSICAL EXAMINATION :APPEARANCEHEIGHTWEIGHT PALLOR, ICTERUS, LYMPH NODES, CYANOSIS, CLUBBING, OEDEMA, DEHYDRATION PALLOR, ICTERUS, LYMPH NODES, CYANOSIS, CLUBBING, OEDEMA, DEHYDRATION

PHYSICAL EXAMINATION VITAL SIGNS : VITAL SIGNS :PULSE BLOOD PRESSURE RESPIRATORY RATE TEMPERATURE BREAST EXAMINATION BREAST EXAMINATION

ABDOMINAL EXAMINATION INSPECTION: INSPECTION: SHAPE, SCAR MARKS, VENOUS ENGORGEMENT, STRIAE GRAVIDARUM, LINEA NIGRA PALPATION: PALPATION: SUPERFICIAL PALPATION: TEMPERATURE, TENDERNESS

ABDOMINAL EXAMINATION PALPATION: PALPATION: FUNDAL HEIGHT FUNDAL GRIP LATERAL GRIP FIRST PELVIC GRIP SECOND PELVIC GRIP: PAWLIK’S GRIP

FUNDAL GRIP

LATERAL GRIP

FIRST PELVIC GRIP

SECOND PELVIC : PAWLIK’S GRIP

ABDOMINAL EXAMINATION AUSCULTATION: AUSCULTATION: FHS: beats / min FETAL TACCHYCARDIA: FEVER, DISTRESS FETAL BRADYCARDIA: CARDIAC ANOMALY

PELVIC EXAMINATION PRE-REQUISITS: PRE-REQUISITS:EXPLANATION EMPTY BLADDER DORSAL POSITION FULL ASEPSIS

PELVIC EXAMINATION INDICATIONS: INDICATIONS: EARLY PREGNNCY: DIAGNOSIS ASSESS PELVIS ADEQUACY DURING LABOUR: ASSESSMENT OF PROGRSS OF LABOUR CONFIRM THE PRESENTATION

INVESTIGATIONS DIAGNOSIS:PREGNANCY KIT DIAGNOSIS:PREGNANCY KIT Hb estimation Hb estimation BLOOD GROUPING BLOOD GROUPING URINE R/M/E and URINE C/S(if signs of infection) URINE R/M/E and URINE C/S(if signs of infection) VDRL(both partners) VDRL(both partners) BLOOD SUGAR BLOOD SUGAR HIV, HEPATITIS HIV, HEPATITIS USG USG

TREATMENT GENERAL GENERAL OBSTETRICAL OBSTETRICAL

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