Antenatal record

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The antenatal record of a reproductive female should be taken when she comes in for her first visit to obstetrics upon pregnancy. It involves the following:

1. Patient identifying data

2. Confirmation of dates: A menstrual history should be taken to decide when the last period was and its regularity. Naegele's rule (add 1 week, subtract 3 months) can be used to predict the date of delivery, and can be confirmed with ultrasound.

3. Past Obstetrical History

  • How many pregnancies has the woman had?
  • What were the dates, gestational ages at delivery, and birthweight?
  • What types of deliveries, or complications were there?
  • GTPAL:

4. Infectious risk: One also pursues the mother's risk for herpes, STIs, varicella and tuberculosis, though other infections can be pursued if necessary.

5. Psychosocial risks: Patients should be challenged on domestic abuse, their living situations, history of depression, and cultural issues.

6. Visit log: It would be super to keep track of gestational age, symphysis-fundal height, wt, BP, FHR and stuff in a visit log.

7. Frequency of visits: The initial assessment should happen before 12 weeks. Thereafter, assessments should happen every 6 weeks to 28 weeks, then every two weeks to 36 weeks, then weekly until delivery. Other testing should be ordered as necessary. Women should also receive date-confirmation and anatomy ultrasounds, as well as screening for genetic anomalies and gestational diabetes.

Ultrasound

The ultrasound is a useful tool for assessing shit in the pregnant woman. The following markers are useful: