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Obstetric history


  • Wash hands
  • Introduce self
  • Ask Patient’s name, DOB and what they like to be called
  • Explain and obtain consent

Presenting complaint

  • Determine symptoms which brought patient in

History of presenting complaint

  • Explore every symptom
  • Relevant systems reviews (see systems review)
    • General
    • Gynaecological (The 4 P’s)
    • Gastrointestinal (βˆ†βˆ† IBS, malignancy, appendicitis, diverticulitis etc.)
    • Urological (βˆ†βˆ† UTI, incontinence etc.)

The 4 P’s

  • PV bleeding

  • PV discharge

  • Pain

  • Pregnancy

    • Fetal movements (if over 16-20 weeks)
    • Contractions/tightening
    • PV blood loss
    • Pre-eclampsia symptoms (headache, visual disturbance, epigastric pain, oedema)

Current pregnancy

  • 1st day of last menstrual period (gestation = time since then) and when +ve pregnancy test
  • Scans so far (intra-uterine? Any abnormalities?)
  • Investigations (especially Rhesus group, Down’s syndrome risk, mid-trimester scan)
  • Problems/admissions this pregnancy
  • Vomiting/hydration

Obstetric history – GMC

Gravida and para

  • Gravida/gravidity = pregnancies
  • Para/parity = birth of fetuses over 24 weeks, regardless if born alive or not

Miscarriages, ectopic pregnancies and terminations

  • Stage
  • Treatment
  • Complications

Children (living)

  • Number
  • Ages
  • Birthweights
  • Type of deliveries
  • Previous problems during pregnancy/delivery

Rest of history as normal

  • PMHx
  • DHx
  • FHx
  • SHx including drugs, alcohol and smoking

Test your knowledge

What is the differential diagnosis for antepartum bleeding?

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Which infections can cross the placenta and cause fetal abnormalities?

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Try some practice OSCE stations…

  1. Abdominal pain during pregnancy
  2. Pre-eclampsia
  3. Antepartum haemorrhage
  4. Find lots more here

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