OB Triage Note SOAP Template:

S:
Past OBHx:
-G1
-G2
etc.

current G: complicated by __.

GBS:
Rubella:
Last U/S: when and what for (add impression from report under radiology tab)
Blood type: (and if rhogam given)

PMHx:

Meds:
Allergies:
Surgeries (and response to General anesthetic)

HPI:
Contractions frequency, duration, strength
Bleeding:
Fetal movement:
ROM:

O:
Comment on NST (1. Baseline 2. Variability 3. Accelerations 4. Decelerations)
Cervix: dilation and effacement (defer cervical exam until review with resident)

A:
__ year old G_P_ presenting with ____ at ____ wks GA.

P:
1. Admit to L&D
2. Start abx if GBS+ (PenG)
3. Epidural (if requested)