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IWAN PRIYONO
Chapter
WILLIAM
Page
207-211
8OBSTETRICS
PRENATAL RECORD
Use of standardized within a perinatal health care
system greatly facilitates antepartum and
intrapartum management.
DEFINITIO
NS
NULLIGRAVIDA : A WOMAN WHO IS NOT NOW AND NEVER HAS BEEN
PREGNANT
GRAVIDA : A WOMAN WHO IS OR HAS BEEN PREGNANT, IRRESPECTIVE
OF THE PREGNANCY OUTCOME. WITH THE ESTABLISHMENT OF THE
FIRST PREGNANCY, SHE BECOMES A PRIMIGRAVIDA, AND WITH
SUCCESSIVE PREGNANCIES, A MULTIGRAVIDA
NULLIPARA : A WOMAN WHO HAS NEVER COMPLETED A PREGNANCY
BEYOND 20 WEEKS GESTATION. SHE MAY OR MAY NOT HAVE BEEN
PREGNANT OR MAY HAVE HAD A SPONTANEOUS OR ELECTIVE
ABORTION (S)
PRIMIPARA : A WOMAN WHO HAS BEEN DELIVERED ONLY ONCE OF A
FETUS OR FETUSES BORN ALIVE OR DEAD WITH AN ESTIMATED
LENGTH OF GESTATION OF 20 OR MORE WEEKS
MULTIPARA : A WOMAN WHO HAS COMPLETED TWO OR MORE
PREGNANCIES TO 20 WEEKS OR MORE
NORMAL PREGNANCY
DURATION
The mean duration of pregnancy calculated from
the first day of the last normal menstrual period
is very close to 280 days, or 40 weeks.
HISTORY
For the most part, the same essentials go into
appropriate history-taking from the pregnant woman
as elsewhere in medicine. Detailed information
concerning past obstetrical history is crucial because
many prior pregnancy complications tend to recur in
subsequent pregnancies.
Psychosocial
Screening
The American College of Obstetricians and
Gynecologists (1999b) has concluded that addressing
psychosocial issues is an essential step toward improving
women's health and birth outcomes.
TABLE. PSYCHOSOCIAL PRENATAL SCREENING QUESTIONS
1. Do you have any problems that prevent you from keeping your
health care appointments?
2. How many times have you moved in the past 12 months?
0123> 3
3. Do you feel unsafe where you live?
4. Do you or any members of your household go to bed hungry?
5. In the past 2 months, have you used any form of tobacco?
6. In the past 2 months, have you used drugs or alcohol (including
beer, wine, or mixed drinks)?
7. In the past year, has anyone hit you or tried to hurt you?
8. How do you rate your current stress levellow or high?
9. If you could change the timing of this pregnancy , would want it
earlier, later, not at all, or no cange?
CIGARETTE
SMOKING
Since 1984, the Surgeon General has required four
specific, rotating health warnings on all cigarette
packages, including: "Smoking by pregnant women may
result in fetal injury, premature birth, and low birthweight"
(United States Department of Health and Human Services,
2000).
DOMESTIC
VIOLENCE
SCREENING
The term domestic violence usually refers to violence
against adolescent and adult females within the context
of family or intimate relationships.
PHYSICAL EXAMINATION
A thorough, general physical examination
should be completed at the initial prenatal
encounter.
PELVIC EXAMINATION
LABORATORY TEST
PELVIC
EXAMINATIO
N
The cervix is visualized employing a speculum
lubricated with warm water.
Laboratory
Tests
The Institute of Medicine recommended that a national
policy of universal screening be developed for human
immunodeficiency virus (HIV) testing, with patient
notification, as a routine part of prenatal testing. The
American Academy of Pediatrics and the American College
of Obstetricians and Gynecologists (2002) support this
recommendation.
TERIMA KASIH