1st period

ISM

Marina Farag

Placental Development Survey Questions:

1.
2.
3.
4.

How old are you?

How old is your baby?
Did you smoke or do drugs before or during pregnancy? (Yes/No)
Have you experienced any abdominal, placental or cardiac diseases in a period of 3 years
before the pregnancy? (Yes/No)
5. Have you experienced any miscarriages or any signs of abnormal development in your
last pregnancy? (Yes/No)
6. What conditions (if any) have you experienced during your pregnancy?
Gestational Diabetes
Rh compatibility
None
7. Have you experienced any of the following during pregnancy?
Bright Red painless vaginal bleeding in the 3rd trimester (week 29 - week 40)
Hypertension (High blood pressure)
Vascular Disease
Low blood pressure
Over-distended (bloated) bladder
Focal uterine contractions
None
8. Have you ever experienced an abnormal placental development? (Yes/No)
9. If answered "yes" to question 8, what were the complications?
Early miscarriage
Preterm labor
Growth Restriction
Preeclampsia ( high blood pressure)
Fetal Death
None
10. Have you ever been diagnosed with placental cancer?