Table of Contents IntroductionPresenting complaintHistory of presenting complaintCurrent pregnancyObstetric history – GMCRest of history as normalTest your knowledgeTry some practice OSCE stations… Introduction 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 Timeframes Symptom-specific questions (see exploring symptoms) Relevant systems reviews (see systems review)General Gynaecological (The 4 P’s) Gastrointestinal (∆∆ IBS, malignancy, appendicitis, diverticulitis etc.) Urological (∆∆ 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? Oops! This section is restricted to members. Which infections can cross the placenta and cause fetal abnormalities? Oops! This section is restricted to members. Try some practice OSCE stations… Abdominal pain during pregnancy Pre-eclampsia Antepartum haemorrhage Find lots more here
