Patient History Form

This is <Mrs. Murphy>, a<28 year old> <schoolteacher>, from <Dublin>, who is <38 weeks
pregnant>with her <third> baby.

Chief Complaint
38 weeks pregnant woman coming for planning of delivery

History of present illness

Focusing our attention on this pregnancy, the first day of <Mrs. Murphy's>last menstrual period (LMP) was
<Sept 18th>. She is <certain || uncertain> of the date, because she <wrote it in her diary || remembers
the day of conception>.She has a <regular><28 day>cycle, and <stopped the combined oral contraceptive
pill> <6 months>before becoming pregnant. By Nageles's rule, her estimated date of delivery is<June
25th>.

She had a positive pregnancy test at <5> weeks. She booked into hospital at <13 weeks> and an ultrasound
scan <confirmed her menstrual dates>. <She felt quickening at ... weeks>.

She opted for antenatal care with <her general practitioner || this hospital>. Her antenatal course was
<normal until she was admitted to hospital on this occasion || normal except for a ... at ... weeks gestation>.

<Mrs. Murphy> was admitted to hospital <4 days> ago. She complained of <...>.

Since coming into hospital, the investigations she made are <....> which showed <2 coils of cord around
the baby neck...>.she is being kept in the hospital<for observation>.

The patient has no history of shivering, fever or any abdominal pains. She has no history for dysurea or
frequency of micturation. Her level of consciousness is normal

Past medical surgical history

The patient have no history of Anemia, Heart Disease, High Blood Pressure, Rheumatic Fever, Thyroid
problem, Cancer, Blood transfusion, Seizures, Liver disease , Asthma, Pneumonia, Diabetes. The patient
have no history of operations and are not on any medications with no history any allergies

Family history
In her family history, In particular, there is <no family history> of diabetes, and <no> twins in the family.
Gynecological history
With regards to <Mrs. Murphy's> past gynecological history...Her last smear test was in <1996>,
it was <normal>, and <all of her smear tests have been normal>.

Obstetrical history
Turning our attention to <Mrs. Murphy's> previous obstetrical history, she has <two girls>, aged <2 and 4
years>.They are <both well>.

If an abnormal pregnancy, full details:

In her first pregnancy, she <was induced> at <39 weeks>, and after <2 hours || 6 hours [depending on if
making start of labour as when enter labour ward]>, <under went a Cesarean section>
because of <fetal distress>.
The cesarean section was performed <under epidural>. The baby weighed <2.5kg> at birth

If a miscarriage, also brief:

<Mrs. Murphy> also had <1> miscarriage <14> months ago at <10 weeks> and <underwent ERPC>