Example Of Obstetric Evaluation

Tatiana is a 23yo, G7 P3033, who was seen for an ultrasound evaluation and to being PNC. She has had some spotty PNC in Orlando, Florida, out of the hospital and states that she has no primary care physician in that state. She has not had any lab work done in the pregnancy but has had a couple of ultrasounds and visits at the hospitals. We will attempt to obtain what records are available from those institutions. She has had 6 previous pregnancies that involve 3 term deliveries and 3 spontaneous losses. Two of those were complete and one did require a D & C. In addition, based on her height and weight at the start of the pregnancy, her BMI was 46.
Her current BMI is 47.

She just moved to the Knoxville area from Orlando about 3-4 weeks ago per her report. She does have positive fetal movement. She states that she did have some bleeding in the first couple months of the pregnancy but has not had any bleeding in the past 2-3 months. She otherwise has no complaints. Her obstetrical history will be discussed further below. …show more content…
Our measurements overall appear to be concordant with this. The amniotic fluid volume is normal and good fetal movement and activity were seen. An overview fetal anatomy assessment was performed, and no major malformations were noted at this time within the resolution of the ultrasound equipment, though some aspects of the fetal heart and spine could not be completed though the cerebellum is