Case summary and examination of Obstetrics Posting

Case synopsis and assessment of Obstetrics Posting Madam NTR is a 34 years of age Malay woman with gravida 4 and equality 3, as of 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 grumblings of per vaginal dying, compression 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 main day of her last ordinary menstrual period was on fifteenth Apr 2010. This was a sudden pregnancy yet both her and her better half needed it. She speculated 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 Maternal and Child H ealth Clinic Gadong at about four months of growth and the dating filter at about four months uncovered boundaries comparing to date. Nonetheless, placenta was noted to be low lying during that check. All through her routine antenatal visits, she was normotensive, not iron deficient 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 through cesarean conveyance because of breech introduction in Hospital Tuanku Jaafar Seremban. She conveyed her initial two youngsters who are the two guys in the time of 2004 and 2005 through 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 past pregnancy were uneventful. S he achieved menarche at 12 years old. It is normal at 28 to 30 days cycle with term of 5 to 7 days. There was neither dysmenorrhea nor menorrhagia. She rehearsed sex interuptus as preventative measure. She never had any PAP smear done already. Past careful, clinical and medicate 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 youngsters in Gadong Jaya Village. She is a housewife. She neither smokes nor drinks liquor. Then again, her significant other fills in as a development laborer. He is a smoker yet not alcoholic. Family salary is roughly RM2000 every month which is scarcely satisfactory for their living. Physical assessment: Madam NTR was alert, cognizant and open. She was not in torment or respiratory pain. Her tallness and weight are 165cm and 76kg individually. Her circulatory strain was 110/80 mmHg; beat rate was 86 beats for each moment of customary cadence and solid volume; temperature was 37â ° C; respiratory rate was 19 breaths for every moment. Every essential sign were inside ordinary range. Upon general assessment, there was no conjunctival paleness, sclera jaundice, palmar erythema or fringe cyanosis. Thyroid organs were not obvious and bosom assessment was unremarkable. There was reciprocal pedal edema up to mid-shin. Cardiopulmonary assessment was unremarkable.