HISTORY OF LABOR Student_____________________________________________________ Course _________Group________ Name of patient________________________________ Age_____ Complaints __________________________________________________________________ __________________________________________________________________ Anamnesis: Extragenital illness_____________________________________________________________ __________________________________________________________________ Menstrual function____________________________________________________________ __________________________________________________________________ __________________________________________________________________ Gynecological anamnesis__________________________________________________________ __________________________________________________________________ Obstetrical anamnesis__________________________________________________________ __________________________________________________________________ __________________________________________________________________ The duration of the pregnancy __________________________________________________________________ __________________________________________________________________ ______________________________________________________________ __________________________________________________________________
Probable date of labor __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Objective investigation: General____________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ puls______________ BP______________________________________________ Obstetric investigation: Pelvimetry__________________________________________________________ __________________________________________________________________ __________________________________________________________________ Height of uterus ___________________ Circumferencia of abdomen____________________ Probably weight of the fetus____________________ Lie of the fetus_____________________________________________________ Position___________________________________________________________ Visus_____________________________________________________________ Presenting part_____________________________________________________ Fetal heart rate_____________________________________________________ Preliminary diagnose___________________________________________________________ __________________________________________________________________ __________________________________________________________________ _________________________________________________________________
PARTOGRAMM The duration of labor _____________________________ The duration of the 1 stage of Labor from____________ to_____ The duration of the 2 stage of Labor
from____________ to____
The duration of the 3 stage of Labor
from __________ to_____
Blood loss______________________________________ Method of prophylaxis of bleeding in the 3 stage of labor____________________ __________________________________________________________________ Status of newborn: Apgar score_______________________________________________________ Weight_________________________ growth_________________________ Complications of labor_______________________________________________ __________________________________________________________________ __________________________________________________________________ Clinical diagnosis__________________________________________________________ __________________________________________________________________ __________________________________________________________________
Teacher______________ Mark_______________