4. Obstetric history. Gestational age and estimated date of delivery
Covers the obstetric history to take at the first antenatal visit, including personal, menstrual, previous pregnancy, medical, family and current-pregnancy questions. Explains gravidity and parity with the TPAL notation and a worked example. Compares ways of dating a pregnancy, from Naegele's rule to ultrasound and clinical signs, with a table of accuracy, and includes a table of fundal height by week. Ends with term, preterm and post-term definitions.
Topic 4 of 61 in the MU Sofia syllabus for Obstetrics and Gynecology (Medicine, Year 5). The free AceMed note covers it in 3 sections, about 197 words (2 min of reading), with 16 flashcards.
In this note
Introduction
Obstetric history: what to ask
Dating the pregnancy
Introduction
A careful history is the first tool of antenatal care: it dates the pregnancy and finds the risk factors that decide how the pregnancy is followed.
Obstetric history: what to ask
Personal data: age (risk under 18 and over 35), occupation, smoking, alcohol, drugs.
Menstrual history: menarche, cycle length and regularity, first day of the last menstrual period (LMP), contraception before conception.
Previous pregnancies: number and outcome, gravidity and parity (G, P), mode of delivery, birth weights, complications (preeclampsia, haemorrhage, preterm birth, caesarean section).
Medical and surgical history: diabetes, hypertension, heart, kidney and thyroid disease, epilepsy, thrombosis, previous uterine surgery.
Family history: genetic disease, twins, diabetes, hypertension.
Current pregnancy: symptoms, bleeding, medicines, first fetal movements.
Gravidity and parity
Gravida is the number of pregnancies of any outcome; para is the number of births after 20–22 weeks. The TPAL form gives Term, Preterm, Abortions, Living children: G3 P1-1-0-2 means three pregnancies, one term and one preterm birth, no losses, two living children.
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