Obstetrics and Menstrual Cycle History Quiz

Includes patient demographics (age, weight, height) and obstetric history.
Parity: number of live births or stillbirths after 24 weeks of gestation.
Nullipara: woman who has never delivered a fetus beyond 20 weeks of gestation.
Multipara: woman who has had two or more deliveries past 20 weeks of gestation.
Gravida: total number of pregnancies, regardless of outcome (abortion, ectopic, normal pregnancy, molar pregnancy).
Nullgravida: woman who has never been pregnant.
Primigravida: woman who has been pregnant once. A woman with two spontaneous abortions and three normal intrauterine pregnancies may be described as G5 P3 A2.

Age at menarche (onset of menstruation).
Cycle regularity.
Duration of each period and cycle length. Example: 13 5/28 regular (meaning menstruation began at age 13, lasts 5 days, and occurs every 28 days).

Early signs: nausea, breast tenderness, frequent urination, fatigue, headaches.
Later signs: heartburn, backache, constipation, fatigue.
Nausea and vomiting: common in first three months; hyperemesis gravidarum is severe form requiring hospitalization.
Increased urination: early and late in pregnancy due to uterine pressure.
Headaches: more frequent during pregnancy.
Feeling hot and sweaty: due to increased cardiac output and peripheral vasodilation.
Dizziness and fainting.
Fatigue.
Varicose veins and hemorrhoids

Epistaxis (nosebleeds): more common in pregnancy, but generally not serious.
Hypertension and pre-eclampsia.
Thromboembolism: six times more likely in pregnancy; leading cause of maternal death in the UK.
Edema: common, affecting over 80% of pregnant women.
Breathlessness.
Heartburn: common in later stages of pregnancy.
Appetite and weight gain: may fluctuate; craving and aversion to certain foods. Weight gain averages 12kg.
Constipation and hemorrhoids.
Backache.
Leg cramps: common, mostly at night.
Hyperpigmentation and stretch marks: due to hormonal changes.

Pregnancy is typically divided into three trimesters of approximately 13 weeks each.
Prenatal period: development of the baby within the uterus (approximately 40 weeks).
Divided into embryonic period (first 8 weeks) and fetal period (weeks 9–26).
Perinatal period: from week 27 to delivery.
EDD (Estimated Date of Delivery): calculated by adding nine calendar months and seven days to the first day of the last menstrual period (LMP). This timeframe considers fertilization and birth as approximately 40 weeks from LMP, sometimes referred to as 38 weeks of gestation.

Miscarriage: spontaneous or induced termination of pregnancy before 20 weeks of gestation.
Causes: chromosomal defects (60%), maternal/paternal factors, trauma, infections, dietary deficiencies, diabetes mellitus, hypothyroidism, anatomic malformations.
One-fourth of cases have undetermined cause.

Threatened abortion: bleeding before 20 weeks of gestation, but the cervix is closed and products of conception remain. 25-50% chance of miscarriage or proceeding with pregnancy.
Management involves bed rest (24-48 hours or until 2 days after bleeding stops), monitoring and gradual resumption of usual activities.
Inevitable abortion: bleeding and cervical dilation, but without expulsion of products of conception. Management involves analgesics (e.g., pethidine) or medications (e.g., ergometrine) if heavy bleeding is present.
Incomplete abortion: expulsion of some but not all of the products of conception. Prompt removal of remaining products is necessary to avoid complications.
Missed abortion: embryo dies, but remains in the uterus. Management typically involves surgical uterine aspiration.
Prostaglandin E2 vaginal suppositories can be used as alternative to surgery.

Preconception therapy: aims to identify and correct factors that contribute to abortion.
Thorough general and gynecologic examination is crucial.
Testing may include polycystic ovaries, thyroid function studies, blood glucose, lupus anticoagulant, and hemostatic abnormalities.
Postconception therapy: early prenatal care and frequent office visits; bed rest may be necessary for bleeding or pain.
Prognosis is favorable if the cause of abortion can be identified and corrected.