Obstetric Tab

Clinical User Guide

Obstetric Tab

Contents:

Antenatal Columns on the Obstetrics tab
Buttons on the Obstetrics tab
Columns on the Obstetrics tab

See also:

The Obstetrics module is used to store an obstetric history and details of antenatal visits for each pregnancy, and is available to female and gender-neutral patients who are 15 years or older (this age minimum can be adjusted via Clinical Options).

The obstetrics display is split into two sections, with the upper displaying information about the patient's pregnancies, and the lower a record of the antenatal visits for the selected pregnancy.

Buttons on the Obstetrics tab
	If the patient is not flagged as being pregnant, clicking this button starts a new pregnancy record. This button is disabled for patients already flagged as pregnant.
	If a patient is flagged as pregnant, clicking this button adds a new antenatal visit for the current pregnancy.
	Clicking this button ends the current pregnancy. You are prompted to enter the details of the birth.
	Allows you to enter the details of the patient's past pregnancies.
	Allows you to enter the results of routine antenatal investigations for the current pregnancy.
	Allows you to open the Parity window and enter Parity details, such as Gravida, Parity, Miscarriages and TOP (Termination of Pregnancy).
	This button is only available for practitioners in South Australia and provides a way to easily printing copies of Screening results on pre-printed stationary for the South Australian Maternal Serum Antenatal Screening Program.


Columns on the Obstetrics tab
Pregnancy	The number of the pregnancy (as recorded in MedicalDirector Clinical). This number is auto-incremented as new pregnancies are added.
LNMP	Last Normal Menstrual Period. This captures the date the LNMP began.
EDC	Estimated Date of Confinement. This is calculated from the LNMP.
EDC By Scan	Estimated Date of Confinement, via ultrasound scan.
Pregnancy Outcome	Options include 'Single Live Birth', 'Induced Abortion', Ectopic Pregnancy' and so forth.
Method of Delivery	Options include 'Caesarian Section', 'Vaginal Forceps' and so forth.
Date	Child's date of birth.
Gest	The gestational age of the pregnancy.
BWeight	The child's weight at birth
Name	The child's name.
Sex at Birth	The child's sex at birth.
Feed	Bottle or breast-fed.
1st Test, 1st Hb, 1st Abs, Urine, Rubella, 2nd Test, 2nd Hb, 2nd Abs, 3rd Test, 3rd Hb, 3rd Abs, Syph, Hep B, Hep C, HIV, CMV	Values entered via the Pathology Results.


Antenatal Columns on the Obstetrics tab
Date	The date of the mother's visit.
Weight	The mother's weight at that visit.
BP	Blood Pressure.
Urine	Free-text to capture the result of a urine test. For example: NAD (No Abnormality Detected) or Blood + or Prot ++.
Oedema	Free-text to capture whether or not oedema is present.
Calc.	The gestational age based on the calculation from LNMP.
Clin.	The gestation age based on the size of the uterus.
Fundal Ht	The number of centimetres from the pubic bone over the protruding baby bump to the top of the uterus.
Foetal Heart	Foetal heart rate. This is a free-text field. As it is not possible to associate heart rates to multiple babies (in the case of twins for example) entering multiple heart rates simultaneously (such as 150+170) is acceptable. Simply writing 'Heart Rate- Present' is also accepted.
Presentation	Baby's orientation (e.g. cephalic, breech).
Comment	Free- text.