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

Try some practice OSCE stations…

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