HROB Notebook
HROB Notebook
Consider these points for ANY aspect of OB/Medical/Social history that may impact current pregnancy.
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differences in initial prenatal
differences in frequency/schedule of visits
additional visits/consults
treatments
antepartum surveillance
labor considerations
post-partum follow-up
OB History
OB History
AMA
AMA
35-39 vs 40+
Increased risk of stillbirth, among others.
Genetic screening, + level II US
Consider perinatology
ASA
Considerations (per age, pt preferences, comorbidities, consultations, etc)
AFI, US 37 wks
NSTs/BPPs, daily kick counts (starting at?)
Induction timing
Medical History
Medical History
Asthma
Asthma
PFTs vs in-office spirometry
possibly increased for med management, repeat spirometry
pulm prn
inhaled steroids
nsts, growth US based on severity and medications
avoid hemabate for PPH
possible stress dose steroids
avoid misoprostol for induction
continue medications
gastric bypass
gastric bypass
Increased r/o kidney and gallstones
No 1h GTT
Q trimester:
CBC, CMP, B12/folate, Vit D, iron panel/ferritin
Growth US's
Consider consults prn: perinatology, surgery, heme
2 prenatal vitamins daily
ACOG 105 Bariatric Surgery and Pregnancy
Screening and Management, Nutrients 2018
Includes discussion of GTT in RYGB vs sleeve
Obesity, BMI >30
Obesity, BMI >30
gdm, sab, fatty liver, OSA, stillbirth, cesarean, operative complications
first trimester trans-vaginal US
early 1 hour
lifestyle counseling?
early anesthesia consult?
HSV
HSV
CDC: “No data support use of antiviral therapy among HSV-seropositive women without a history of genital herpes.”
Social History
Social History
Alcohol use, current
Alcohol use, current
ensure 1st trim US for base growth
?withdrawal
perinatology, counseling
routine growth US
SW involvement
therapy
more freq for monitoring
BF un if continued drinking
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