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NAME, AGE JOB, FROM GRAVIDA,PARA, GEST WEEK P/C

BABY -WEIGHT -NEONATE ? -WHY? POST COMP -ANTENATAL -LABOUR

H/PC -POSTNATAL CURRENT Hx LMP-DATE, SURE HOW-diary/remember PERIOD -REGULARITY -DAYS OF CYCLE -BLEEDING DURATION PAST OBS HX HOW MANY CHILDREN, AGE WHO TAKES CARE ,HAPPY? 1 GRAVIDA MODELIVERY -WHY ANAESTHESIA -M/C (ERCP?) GEST WEEK -BLEEDING IN BETWEEN -HEAVY -PMS CONTRACEPTION -TYPE -HOW LONG -COMPLICATIONS -STOP ? WHEN PRIOR TO PREGNANCY

2 GRAVIDA

3 GRAVIDA

PREGNANCY -PLAN? -UNPLANNED (WHAT HAPPEN)fail OCP? -PERICONCEPTUAL FOLIC ACID - +VE PREGNANCY TEST -BOOK INTO HOSPITAL AT (W) -FETAL MOVEMENT (W) -COMPLICATION EG bleed,vomit,pain RHESUS &RUBELLA PLAN AFTER BIRTH -OFF WORK (how long) -SUPPORT AT HOME Husband reliable? -WILL BREASTFEED ALLERGIES MEDICATION

PAST MEDS/SURGERY Hx

PAST SEXUAL Hx -STI -PARTNERS -ACTIVE FAM Hx -DIABETES -EPILEPSY -HTN -THROMBOPHILIA -CARDIAC -CANCER -TWIN SOCIAL Hx -smoking (weeks stop prior to) -alcohol (weeks stop prior to) -drugs abuse -married -husband/partner working -house/apartment -children look by, happy -take supplement

PAST GYNAE Hx

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