Clinical Pearl

Some practitioners use a four-digit parity system to designate the number of Term deliveries, number of Preterm deliveries, number of Abortuses, and number of Live births (TPAL system). For example, G2 PI001 indicates gravidity = 2 (two pregnancies including the current one), parity 1001 = 1 prior term delivery, no preterm deliveries, no abortuses, and I living.

2. Last menstrual period (LMP): The first day of the last menstrual period. In obstetric patients, the certainty of the LMP is important in determining the gestational age. The estimated gestational age (EGA) is calculated from the LMP or by ultrasound. A simple rule for calculating the expected due date (EDD) is to subtract 3 months from the LMP and add 7 days to the first day of the LMP (example: an LMP of 1 November equals an EDD of 8 August). Because of delay in ovulation in some cycles, this method is not always accurate.

3. Chief complaint: What is it that brought the patient into the hospital or office? Is it a scheduled appointment or an unexpected symptom, such as abdominal pain or vaginal bleeding in pregnancy? The duration and character of the complaint, associated symptoms, and exacerbating and relieving factors should be recorded. The chief complaint engenders a differential diagnosis, and the possible etiologies should be explored by further inquiry. For example, if the chief complaint is postmenopausal bleeding, the concern is endometrial cancer. Thus, some of the questions should be related to the risk factors for endometrial cancer, such as hypertension, diabetes, anovulation, early age of menarche, late age of menopause, obesity, infertility, nulliparity, and so forth.

From PMS To PPD

From PMS To PPD

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