OBSTETRICAL HISTORY

a. Menarche : 12 years old d. LMP : July 23, 2016

b. EDC : April 30, 2017 e. Trimester :
c. AOG : 27 weeks and 4 days g. G : 1 P : 0 TPAL: (0000)

INITIAL PHYSICAL ASSESSMENT

Breast
1. Size Equal [ ] Unequal [ ]
2. Shape Symmetrical [ ] Asymmetrical [ ]
Remarks :________________________________
Nipples
Inverted [ ] Everted [ ] Lump [ ]
Discharges :______________________________
Color
Pinkish [ ] Increased vein [ ]
Remarks :________________________________
Abdomen
Linea Nigra [ ] Striae Gravidarum [ ]
Other skin impairment [ ]
Remarks :________________________________
Perineum
Scars [ ] Wartz [ ] Rashes [ ] Varicosities [ ]
Discharges [ ]
Color : Yellow Odor :____________
Appearance : Transparent [ ] Turbid [ ]
 INITIAL PHYSICAL ASSESSMENT

Height : 411 Weight : 60kg Fundic Height : 39cm

VITAL SIGNS

Bp : 120/80 mmHg PR : 73 bpm RR : 18 cpm

Temp : 37.2 C

SIGNS OF PREGNANCY

First Trimester

1. Presumptive Signs Amenorrhea [ ] Chadwick Sign [ ]

Nausea & vomiting [ ] Gonadotropic exams [ ]
PICA [ ] Tenderness & Enlargement of the
Breast [ ]

2. Probable Signs Hegars sign [ ] Uterus within abdomen [ ]

Changes in Shape, Size and Goodells Sign [ ]
Consistency of the Uterus [ ]

Second/Third Trimester
Quickening [ / ] Date: 4th month of pregnancy Uterine enlargement apparent [ ]
Chadwicks sign [ ] Uterine souffl [ ]
Melasma [ ] Braxton Hicks contraction [ ]
Darkening of Areola [ ] Linea nigra [ ]
3. Positive Signs
X-ray outline of the Fetal Skeleton [ ]
Fetal movement felt by the examiner [ ]
Fetal heartbeat audible with stethoscope [ ]