gynecology and obstetrics
Evaluation of the Obstetric Patient
History
During the initial visit, clinicians should obtain a full medical history, including Previous and current disorders Drug use (therapeutic, social, and illicit) Risk factors for complications of pregnancy (see table Risk Factors for Complications During Pregnancy ) Obstetric history, with the outcome of all previous pregnancies, including maternal and fetal complications (eg, gestational diabetes, preeclampsia, congenital malformations, stillbirth) Family history should include all chronic disorders in family members to identify possible hereditary disorders ( Preconception or Prenatal Carrier Testing of Parents ). During subsequent visits, queries focus on interim developments, particularly vaginal bleeding or fluid discharge, headache, changes in vision, edema of face or fingers, and changes in frequency or intensity of fetal movement. Gravidity is the number of confirmed pregnancies; a pregnant woman is a gravida. Parity is the number of deliveries after 20 weeks. Multifetal pregnancy is counted as one in terms of gravidity and parity. Abortus is the number of pregnancy losses (abortions) before 20 weeks regardless of cause (eg, spontaneous, therapeutic, or elective abortion; ectopic pregnancy). Sum of parity and abortus equals gravidity. Parity is often recorded as 4 numbers: Number of term deliveries (after 37 weeks) Number of premature deliveries (>20 and<37 weeks) Number of abortions Number of living children Thus, a woman who is pregnant and has had one term delivery, one set of twins born at 32 weeks, and 2 abortions is gravida 5, para 1-1-2-3. 