1 - O+G - Hx + Ex - Postnatal Hx, Ex, Ix, MGMT Flashcards
first things?
name and age of mum and # of days since delivery
9 parts of history
delivery infant Hx of puerperium so far drugs plans for the puerperium Hx of preg and obst Hx SHx VTE risk presentation
delivery Hx
Gestation MoD - why if not NVD mode of onset length of labour analgesia blood loss?
infant Hx
name, sex, birth wt, apgar scores, cord pH, mode of feeding, vit K given
Hx of puerperium so far
lochia (vol, odour) bowels opened? urine output normal or difficult? leaking or dysuria? pain, esp in perineum?
Plans for puerperium?
contraception intended?
POP suitable for BF mothers
COCP can start 4-6wks if bottle fed
help available at home?
Hx of preg and obst Hx?
parity, major antenatal complx, eg preeclampsia, DM
how to present?
Mrs X, aged XX had a XX delivery XX days ago and delivered a M/F XXkg infant, with agpar of XX and labour was (mode) at XX weeks gestation and lasted XX hours. This was her XX pregnancy, which (any COMPLx). She is currently (brief assessment - eg BP, anaemia, uterine involution), is (bottle/breast) feeding and plans to use XX as contraception. Her risk of VTE is XX and so fragmin prophylaxis is (not) required
postnatal Ex - 2 parts? what Ix is routine? for? what else might be done?
general and abdominal
FBC
anaemia
any Ix needed RE any complications
things examined in general postnatal Ex
mood, appearance, temperature, pulse, BP, anaemia,
also chest, breasts, wounds, IV sites, legs (DVT) if fever or tachycardia
things examined in abdo exam?
uterine involution
and a palpable bladder - examine perineum if painful
MGMT of postnatal mother
analgesia mobilise asap fluids if not eating or drinking VT test patients ( majority will get LMWHep + TED stockings discharge plan baby check
