Case summary and examination of Obstetrics Posting

Case outline and assessment of Obstetrics Posting Madam NTR is a 34 years of age Malay woman with gravida 4 and equality 3, right now at 37 weeks of growths. She was conceded on 21st Nov 2010 at gestational age of 30 weeks and 1 day, because of referral from Health Clinic Sendayan taking into account placenta previa dependent on ultrasound discoveries during a routine antenatal visit. Her evaluated date of conveyance was on twentieth Jan 2011. She was asymptomatic without any objections of per vaginal dying, withdrawal torment, spilling alcohol or show. Fetal developments were felt and were not decreased. She has no history of placenta previa in her past pregnancies. The principal day of her last typical menstrual period was on fifteenth Apr 2010. This was a surprising pregnancy however both her and her significant other needed it. She presumed she was pregnant when she missed her menses for about a month. She affirmed her pregnancy after pee pregnancy test done in a private center yielded positive outcome. Booking was done in Mater nal and Child Health Clinic Gadong at about four months of growth and the dating examine at about four months uncovered boundaries comparing to date. Be that as it may, placenta was noted to be low lying during that filter. All through her routine antenatal visits, she was normotensive, not pale and didn't have diabetes mellitus. HIV and VDRL test were negative. Her blood bunch type is O Rh Dâ positive. This is her fourth pregnancy. Her third pregnancy was in the time of 2007. She conveyed a full term infant kid with birth weight of 2.6 kg by means of cesarean conveyance because of breech introduction in Hospital Tuanku Jaafar Seremban. She conveyed her initial two kids who are the two guys in the time of 2004 and 2005 by means of unconstrained vaginal conveyance, with birth weight of 4.26kg and 2.6kg individually. There was no history of shoulder dystocia. Every one of her kids were brought into the world fit as a fiddle. Antenatal, natal and postnatal for every single past pregna ncy were uneventful. She accomplished menarche at 12 years old. It is customary at 28 to 30 days cycle with length of 5 to 7 days. There was neither dysmenorrhea nor menorrhagia. She rehearsed copulation interuptus as prophylactic measure. She never had any PAP smear done beforehand. Past careful, clinical and tranquilize history were unremarkable. Family ancestry was unremarkable. She and her significant other are hitched for a long time. They are remaining along with their three kids in Gadong Jaya Village. She is a housewife. She neither smokes nor drinks liquor. Then again, her better half fills in as a development laborer. He is a smoker yet not alcoholic. Family pay is around RM2000 every month which is scarcely sufficient for their living. Physical assessment: Madam NTR was alert, cognizant and informative. She was not in torment or respiratory trouble. Her stature and weight are 165cm and 76kg separately. Her circulatory strain was 110/80 mmHg; beat rate was 86 beats for eve ry moment of standard cadence and solid volume; temperature was 37â ° C; respiratory rate was 19 breaths for each moment. Every single crucial sign were inside typical range. Upon general assessment, there was no conjunctival whiteness, sclera jaundice, palmar erythema or fringe cyanosis. Thyroid organs were not tangible and bosom assessment was unremarkable. There was two-sided pedal edema up to mid-shin. Cardiopulmonary assessment was unremarkable.