*choking*

Hello, welcome to another section of being nurse Vianly. LOL. Mockward day 2: Obstetric history taking (EDD calculation included), and Heimlich Maneuver.

In obstetric history, we are required to gather information, basic info like name, age, DOB, address, and etc,etc. Then medical, surgical history, (now next time when you come for an antenatal (before birth) visit for the first time, don't be angry with the staff who will be conducting the interview, everything that will be ask will contribute the the health care plan. Well, except when they ask you something really irrelevant than you can politely point out the irrelevantness, hehe), family history (this is important, for example, if the pregger said that she have a mother who have a diabetes then we are going to conduct a special test called the Oral Glucose Tolerance Test (OGTT). If your family members have certain diseases such as hypertension, or diabetes (common diseases), then your chances of getting it are slightly high than those who don't have. But having said that, having a hypertensive dad or diabetic mom doesn't mean that you will have that diseases. It's all in your lifestyle. You will have just a risk factor then. A lot of people are confuse about this.


Okay so, here comes the fun part. The gravida and parity thing. I like this. LOL. Gravida means, a pregnant woman. So next time, you can say, oh she's gravida. LOL. Just joking kay. Gravidity refers to the numbers of times the woman have been pregnant. Primigravida or gravida 1, is a woman who is pregnant for the first time, or has been pregnant one time. Multigravida or more specifically, gravida 2, gravida 3, gravida 4 and so on, is a woman who has been pregnant for more than one time. A nulligravida or gravida 0, is a woman who has never been pregnant.

So we come to parity. Parity (in medicine) is a term that refers to the number of times a woman has given birth. As long as she given birth, then we can count it as parity. Usually primigravida is called primip, multigravida is multip. Back in semester two, I was like what the hell are they talking about primip, multip, but never bothered to asked, I've learn my mistakes there. OBG is quite fun actually, once you get over past the craziness within.

So, when you see (in a clinic card), G8P7+1, well it is simply like this, so the woman is pregnant or has been pregnant 8 times. Given birth 7 times, and have an abortion or miscarriage or stillbirth once (hence the +1, if it's two times then it's +2). Hurm, let's see, if it's G7P8, it means, the woman have twins. It's a little bit confusing here. Let's go back to the term parity. "Number of times the woman has given birth", so, twins, this is common sense, the mother have to give birth to two babies, so, they are not going to come out together, one have to come out first. Ehhe.

Obstetric history is kinda confusing especially the gravida and parity part. You really have to ask questions carefully. And is OSCE (practical exam), it's really hard to ask because of nervousness and all that. So here are some tips (from the so called senior, hehe).

1. You have to greet the patient and explain what you want to do.
2. If there is a chair beside the patient, ask for permission to sit, e.g. If there is no chair, take the paper and the pen, and stand beside the patient.
3. Ask the name, if you are not sure of the spelling, ask the patient to spell it.
4. Ask the age.
5. Ask the gravida and parity, THIS IS IMPORTANT. Do not panic.
6. Ask the LMP (last menstrual period), again, this is MUY IMPORTANTE, and straight away calculate the EDD (expected date of delivery, so girls and boys, memorize the plus 7 to the days, and 9 to the months). Tell the patient her EDD.
7. Ask her about her last pregnancies. So, even if she said she is on her 8th pregnancies, or even 20th, don't panic, you only have to ask about her last pregnancies. Gestation weeks when the baby was delivered, place of delivery, types of delivery (SVD, LSCS, forceps, vacuum), her baby's weight, gender, any complications, did she breastfeed or bottle feed her baby and for how many months.
8. Then you can ask her every questions you can remember. And ask only OBG related. Don't go asking the patient, "Have you ever been in an accident?". You are wasting your time, and if you are unlucky (you are already wrong for asking the wrong questions,) the invigilator sure will scold you on the spot.

In OSCE, you will only have 5 minutes to complete the procedure/question. The LMP, EDD, gravida and parity are important. Make sure you ask these questions first, after you ask the name and age. You are going to lose lots of marks if these are not included in your obstetric history taking. Make sure you write everything in a piece of paper that have been provided. The invigilator will check later. Don't try to fool them. They are all are experiences nurses. Even if they seems not to be looking at you, they are actually are. Trust me. They are more alert than the fire alarms. When you have 20 patients in the ward, you will become more alert than usual.


Do not panic, or you will utter something like "do you breast cancer your baby or botol?" This is a true event happened to one OSCE. Thank God, I didn't said anything like that. It was funny, but the marks also became "funny".


All the best for your OSCE .


xoxo