1. Anamnesis.
1.1. Passport data.
1.2. Complaints.
1.3. Conditions of work and life.
1.4. Heredity in man and woman families (mental disease, blood disorders, metabolism, and the presence of intoxication (alcoholism, drug addiction, smoking).
In order to organize perinatal health of the fetus must clarify age, health man, his blood group and Rh affiliation, and the presence of harmful factors related to the profession and bad habits in marriage.
In the presence of harmful or severe conditions women at the first reference to it, a certificate of exemption from the need for hazardous and difficult conditions pct.
1.5. Postponed disease.
1.6. Menstrual function. 1.7.Sekretorna function.
1.8. Sexual function.
1.9. Fertility.
1.10. The course of the current pregnancy.
2. Physical examination.
• Measuring temperature, pulse, blood pressure determination on both hands;
• Overview of the skin and mucous membranes;
• Examination of organs and systems: conduct auscultation of heart, lung, thyroid and palporalne study of breast lesions for diagnosis, assess the shape of the breast nipples.
• Measurement of body weight women.
3. Special obstetric examination:
External midwifery survey - carried out by inspection, measurement, palpation and auscultation.
Examination of pregnant women.
Pay attention to: height, build, completeness, condition of the skin and breast, stomach.
Examination of internal organs.
Pelvic examination - carried out by inspection, palpation and measurement.
Evaluation sacral character diamond.
Determine the transverse dimensions of the pelvis:
Distantia spinarum - the distance between the anterior upper ostyamy pelvic bone - is 25-26 cm;
Distantia cristarum - the distance between the most viddalynymy points iliac crest - is 28-28 cm;
Distantia trochanterica - the distance between the most viddalynymy points greater trochanter femur - is 30-31 cm;
Conjugata externa - the distance between the mid-upper - outer pubic joints and over the sacral fossa, is 20-21 cm;
Conjugata vera - subtracting the value sonjugata externa 9 cm, we obtain the approximate size of the real conjugates equal to 11cm.
Conjugata diagonalis - the distance from the lower edge of the symphysis to the sacral promontory point that most advocates - is 12,5-13 cm.
If reduction of at least one of the main dimensions of the pelvis at 1.5 - 2 cm should be measured subsidiary size and specify the form and degree of narrowing of the pelvis.
Transverse size of the pelvic outlet - the distance between the inner surfaces of the buttocks - to data obtained 9-9.5 cm add 1.5 - 2 cm transverse size of the output normal pelvis is 11 cm.
Direct pelvic outlet size - the distance between the middle of the lower edge of the pubic joint and the tip of the coccyx. From the data obtained 11 cm subtracted 1.5sm Direct output normal pelvis size is equal to 9.5 cm.
Oblique pelvic dimensions measured when there is a suspected or kosozmischenyy kosozvuzhenyy pelvis.
Measurement of pelvic tilt - the angle between the plane of the entrance to the pelvis and the plane horizon, standing in the position of women 45-55 °. Research pubic angle - at normal size pelvis it is 90-100 °.
Imagination on the thickness of the bones of the pelvis and is able to index Soloviev - circumference in the area of the wrist (14 cm).
Vaginal examination. Vaginal examination is mandatory inspection of the cervix and vagina in the mirror. In women with physiological pregnancy and in the absence of changes in the area of the cervix and vagina internal midwifery research done 2 times (when registering and gestation 30 weeks). The frequency of these internal investigations determined by obstetric indications.
At various stages of pregnancy uterine size on average meet:
4 weeks - the size of an egg;
8 weeks - size women's fist;
12 weeks - 3 cm above the womb (the size of the head of the newborn);
16 weeks - 12 cm above the womb (in the middle of the distance between the navel and vagina);
20 weeks - 16 cm above the womb (2 cross fingers below the navel);
24 weeks - 20 cm above the womb (at the navel);
28 weeks - 24 cm above the womb (at 2-2.5 cross fingers above the navel);
32 weeks - 28 cm above the womb (in the middle of the distance between the navel and the xiphoid process);
36 weeks - 32 cm above the womb (at the costal arch);
40 weeks - 32 = 34 cm (halfway between the navel and the xiphoid process).
Primary complex laboratory testing pregnant include blood tests, urinalysis, blood grouping and Rh factor, blood test for syphilis, HIV (the agreement), bacterioscopic smears from the vagina, cervical canal, urethra (column B). Polling station obstetrician-gynecologist performed pre - and post-test counseling pregnant women about HIV research.
According to the history and midwifery research, completed medical records, determined by the amount of laboratory research, with the consent of pregnant fills the questionnaire.
The first time obstetrician-gynecologist filled "Individual Card pregnant and mothers" (Form 111 / U) and exchange card (Form 113 / o). Exchange card is pregnant from the moment of its registration vzattya about pregnancy.
The optimal number of doctor visits for pregnant observation period for prenatal stage averages 10 - 12 times.
Upon further observation and provided an uncomplicated pregnancy rate prenatal visits within 30 weeks of - 1 per month, and after 30 weeks - one every two weeks.