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History
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1. Confirmation of gestation
a. Presenting symptoms of pregnancy i. Amenorrhoea ii. Nausea/ vomiting – at all hours of the day iii. Breast tenderness – cos of engorgement iv. Quickening = woman’s initial awareness of fetus movt w/in uterus b/w 18-20 weeks (wide variations & subjective), unreliable for 8-9 weeks v. Emotional changes – constantly pms vi. Skin changes – eczema flare up, pigmentation >pronounced b. Last menstrual period (LMP) i. Period of amenorrhoea NOT= true gestation in 30% of preg (irreg cycles, poor memory, bleeding in early preg mistaken for menstruation) ii. Do not rely on LMP alone to date preg if access to U/S is available |
2. Menstrual history a. Regularity – if yes, ask “had your menses ever been delayed for few days, 1-2 weeks, occasionally 1 month?” b. History of heavy or painful menses c. Last menstrual period i. Normal timing ii. Normal duration iii. Normal amount – no of pads used iv. Note: even in women w regular 28 day cycles – 20% chance of wrong gestational age |
