HISTORY TAKING

-K.U . ANU BUVANA

• PATIENT’S DETAILS

• PRESENT COMPLAINTS
• MENSTRUAL HISTORY
• MARITAL HISTORY
PRESENT OBSTETRIC HISTORY
Ist TRIMESTER

IInd TRIMESTER

III rd TRIMESTER – H/O Suprapubic pain

palpitations ,dizziness
PAST OBSTETRIC HISTORY
• History of pre-eclampsia, anemia or pregestational
diabetes.
• Gestational age at which caesarean section was done
( term / Preterm)
• Indication
• Emergency or Elective

Elective LSCS
• Find out the indication – Malpresentation ,CPD,
FGR, Bad obstetric history
EMERGENCY LSCS
• How long the patient was in labour?
• When did the membranes rupture?
• Was there any induction or acceleration of
labour performed ?
• History of prolonged labour /failed forceps
delivery/failed trial of labour.
• Antepartum hemorrhage / malpresentation
• History of blood transfusion
POSTOPERATIVE
• Abdominal distension,Urinary tract
infections,fever in peurperium ,foul-smelling
lochia, wound infection – all these indicate
postpartum sepsis.
• Associated with poor healing weak scar and
lessen uterine integrity.
• Resuturing
• Duration of hospital stay.
• H/O Contraceptive Usage
Past history

• Medical :
• Hypertension, diabetes , heart disease , epilepsy
• Surgical – previous uterine surgeries like
myomectomy/ repair of uterine rupture.

• Personal history : smoking

Regarding the baby:
• Cried immediately after birth,
• Birth weight
• If the baby was with the mother or in NICU
• Condition Of The Baby At Present.
 EXAMINATION

GENERAL EXAMINATION:

•Maternal tachycardia- early indication of scar dehiscence.

•Spinal Deformity / Polio / Dystocia Dystrophica Syndrome

•ABDOMINAL EXAMINATION:

Nature Of Abdominal Scar – Vertical Midline , Paramedian Or

Pfannenstiel.

•Presence Of Puckering, Keloid, Incisional Hernia Over The

Scar.
 •PALPATION – Suprapubic Tenderness Or Bulge, From Right To Left To
Elicit Uterine Scar Tenderness.

•Vertical Scar- Palpate For Suprapubic Tenderness.

• Palpation Is Performed To Find Fetal Lie , Presentation and Position , Head Is
Engaged And Size Of Fetus To Decide About Vaginal Birth After Caesarean Section
(VBAC )

• EASY PALPATION OF FETAL PARTS - UTERINE RUPTURE.

AUSCULTATION : Fetal Heart Rate Decceleration Is An Early Sign Of Scar

Dehiscence.

• PER VAGINAL EXAMINATION

INVESTIGATIONS:

• ROUTINE URINE AND BLOOD INVESTIGATIONS

• USG :
• Confirm Gestational Age ,
• Liquor Volume,
• Estimated Fetal Weight
• Presentation,
• Placental Position
• Scar Thickness Assessment : >3.5 mm
• Herniation Of Decidual Tissue Through A Weak Scar.

• NST : FETAL HEART RATE