Fundic height and estimated fetal weight

Blood type Rh: 24 2015

( 1ST, 2ND,3RD,4th ) pncu
LMP:
HBsAg: 25 2170
VDRL:
edc: HIV: 26 2325
Aog by: Lmp or by FBS OR 27 2480
Utz ( <12 weeks) 75 g OGTT:
SHOULD BE IN MG/DL, IF IN MMOL
MULTIPLY IT TO 18
28 2635
1ST HR:
2ND HR:
29 2790
30 2945
RD
3 hr:
General data:
31 3100
Past medical history:
(-) HTN (-) Asthma since when? meds? compliance 32 3255
(-) DM (-) goiter 33 3410
(-) BT (-) previous surgery excepT ob
Family history
(-) HTN
(-) DM
(-) Asthma
(-) goiter
SOAP CHARTING
Personal social history (+) Good Fetal movement
3/8 sibling, hs graduate, employed, married to or living in with a
tricycle driver
( - ) vices ( - ) allergy
s> (-) Abdominal pain
(-) watery / mucoid / bloody discharge

Conscious, coherent, nicrd

Ob gyne history Bp: cr: rr: temp:
m- enarche Coitarche: As, ppc, (-) Nad, (-) Clad, (-) TPC
I - nterval # of sexual partners: Sce, cbs, (-) retractions
D – uration Last sexual contact: Ap, nrrr, (-) murmur
A - # of pads contraceptive: Flabby or globular, soft, non tender
S - ymptom fh: efw: fht:
se: FOR THE 1st pncu AND <33 weeks aog
G_P_ (TPAL) pap smear <33 weeks aog
G1 (2000) FT, NSD, NFMC (no fetomaternal complications) - There should be no sexual
G2 (2002) Abortion, d&C, IUFD contact for 7 days

O>
G3 (2004) PT, CS 1 type unknown 2 to malpresentation, pes, - No bleeding
Findings:
Visualization of cervix and vaginal wall
color (pinkish or violaceous)

Labs & meds

(+/-) smooth / with lesion
(+/-) laceration, erosion, ulceration,
discharge/bleeding

Ie: You only do Internal examination if it is

Cbc WITH PC the patient’s

labs
BT RH - 1st prenatal check up
UA - term
HBSAG, VDRL, HIV findings: consisteny (firm or soft)
open or close
FBS (<26 WEEKS) if open:
75 G Ogtt (>26 WEEKS) - dilatation. Effacement,
PAP SMEAR: presentation, station, (-) bow
- There should be no sexual - +/- discharge/bleeding
GNE, FEPP, (-) CYANOSIS, (-) EDEMA
contact for 7 days
-

- up to 31 weeks
G __P__ (TPAL)
Pregnancy uterine _____ weeks aog

meds
< 12 weeks
Multivitamins od
Folic acid od
> 12 weeks
Multivitamins od
Calcium bid
a> Not in labor / in labor
previous cs i type uknown sec. to _____________
Ferrous sulfate od other diagnosis

<12 WEEKS TVS Chronological order

utz
13- 27 WEEKS PELVIC UTZ Labs – e.g (for utz, bps, 75 g ogtt, ua, cbc)
Meds: Continue oral medications
28-36 WEEKS BPS
( FES04 od, mV od, calcium bid, folic acid
> 37 WEEKS
32-34 WEEKS
BPS WITH NST
Placental color mapping P> (<12 weeks)
DIET: dm diet/ lslf diet/well balanced diet
Advised 10 danger signs of pregnancy
Advised fetal movement counting
4 - 28 WEEEKS EVERY MONTH Primi: 18-20 WEEKS
FOLLOW 29 – 36 WEEKS EVERY 2 WEEKS multii: 16-18 WEEKS
UP > 37 WEEKS EVERY WEEK Increase oral fluid intake
Tcb after _______ weeks
 Sample
Pap smear prescriptions
2ND SMEAR: Ectocervix

1st smear: ENdocervix

3RD SMEAR: VAGINAL wall

Seminary road, edsa, quezon city

VDRL screening
hbsag
Dip the slide to 90% alcohol then air dry. return it To the
patient along with the prescription for laboratory testing

Seminary road, edsa, quezon city

Seminary road, edsa, quezon city

Hiv screening c/o

bahay kalinga

10 Danger signs
of pregnancy
Seminary road, edsa, quezon city

75 grams ogtt

Seminary road, edsa, quezon city

Multivitamins 500 MG OD
SIG. TAKE ONE TABLET ONCE A DAY

CALCIUM TABLET
SIG. TAKE ONE TABLET ONCE A DAY // 1 tabLet 2x a day

FERROUS SULFATE TABLET

SIG. TAKE ONE TABLET ONCE A DAY
 LEOPOLDS MANEUVER
1ST MANEUVER: FUNDAL
GRIP
Purpose: To determine which fetal
pole – that is,
cephalic or podalic – occupies the
uterine fundus
With the tips of the fingers of the two
hands, the abdomen is felt to see
which fetal pole occupies the uterine
fundus
 Breech - Large, nodular mass
 Head - Hard, round and is more
mobile and ballottable
 Ballottable - When you press it
down, it will bounce back
2ND MANEUVER: LUMBAR GRIP
Purpose: To identify on which side of
the mother is the fetal back located
Palms are placed on either side of the
maternal abdomen, gentle but deep
pressure is exerted
Fetal Back Hard, resistant
structure
Fetal Extremities Numerous,
small, irregular, mobile parts
LEOPOLDS MANEUVER
3RD MANEUVER: PAWLICK’S
GRIP
Performed by grasping with the
thumb and fingers of one hand the
lower portion of the maternal
abdomen just above the symphysis
pubis
Not engaged A movable mass
will be felt
4TH MANEUVER: PELVIC
GRIP
Purpose: To determine on which side
of the fetus is the cephalic
prominence felt
With the tips of the first three fingers
of each hand, exerts deep pressure in
the direction of the axis of the pelvic
inlet . When the head has descended
into the pelvis, the anterior shoulder
may be differentiated readily by the
3rd maneuver
 Vertex Presentation - prominence
is on the same side as the small
parts
 Face Presentation - The
prominence is on the same side as
the back

ASSESSMENT OF GESTATIONAL AGE

FUNDAL HEIGHT
- 20 – 34 weeks
- Height of the fundus (cm) correlates with AOG in weeks
- Distance over the abdominal wall from the top of the
symphysis pubis to the top of the fundus
- Bladder must be emptied before making measurement
o A full bladder can add about 3cm to the fundic
height

FETAL HEART SOUNDS

- As early as 16 weeks
- Audible in all by 22 weeks
- 10 weeks – Doppler
- 5 weeks – TVS

ULTRASOUND
- If performed between 8 – 16 weeks was accurate by 2
days for predicting the actual date at delivery