Family History

 FAMILY HISTORY

 

The family history should list illnesses occurring in first-degree relatives, such as diabetes, cancer, osteoporosis, and heart diseases. Information gained from the family history mayindicate a genetic predisposition for a hereditary disease. This in-formation may guide selection of specific tests or other in-terventions for the surveillance of the patient and perhaps other family members. Preconceptional counseling also may be offered.

Comments

Post a Comment

Popular posts from this blog

Major Causes of Postpartum Hemorrhage and their Management

Image
  MAJOR CAUSES OF POSTPARTUM HEMORRHAGE AND THEIR MANAGEMENT   Uterine Atony   Ordinarily, the uterine corpus contracts promptly after delivery of the placenta, constricting the spiral arteries in the newly created placental bed, and preventing excessive bleeding. This muscular contraction, rather than coagu-lation, prevents excessive bleeding from the placental implantation site. When contraction does not occur as expected, the resulting  uterine atony  leads to PPH. Conditions that predispose to uterine atony include those in which there is extraordinary enlargement of the uterus (such as polyhydramnios or twins); abnormal labor (both precipitous and prolonged, or augmented by oxy-tocin); and conditions that interfere with contraction of the uterus (such as uterine leiomyomata or magnesium sulfate). The clinical diagnosis of atony is based largely on the tone of the uterine muscle on palpation. Instead of the normally firm, contracted uterine corpus, a softer, more pliable— often cal
Read more

Cardiac Disease during pregnancy

Image
  CARDIAC DISEASE   With earlier diagnoses and more effective treatments, more women with congenital and acquired heart disease reach adulthood and may become pregnant. Patients with rheumatic heart disease (caused by untreated or delayed treatment of group A–hemolytic streptococcal [GAS] ton-sillopharyngitis) and acquired infectious valvular heart dis-ease (often associated with drug use) comprise only 50% of pregnant cardiac patients. The remainder consists of other cardiac conditions that traditionally have been less commonly seen in pregnancy.  Because pregnancy is itselfassociated with an increase in cardiac output of 40%, the risks to mother and fetus are often profound for women with pre-existing cardiac disease.  Ideally, cardiac patients should havepreconceptional care directed at maximizing cardiac func-tion. They should also be counseled about the risks their particular heart disease poses in pregnancy.   Classification of Heart Diseases in Pregnancy   The classification of
Read more

Intrapartum Fetal Heart Rate Monitoring

Image
  Intrapartum Fetal Heart Rate Monitoring   Fetal heart rate (FHR) monitoring  is a modality in-tended to determine if a fetus is well-oxygenated. The ma-jority of neonates (approximately 85%) born in the United States are assessed with  electronic fetal monitoring(EFM),  making it the most common obstetric procedure.  Intermittent auscultation  of the FHR after a contractionalso is used to assess intrapartum fetal well-being. Beginning  in the 1980s, EFM became more common; rates of its use have doubled over the past 35 years. EFM may be performed externally or internally. Most external monitors use a Doppler device with computerized logic to interpret and count the Doppler signals. Internal FHR monitoring is accomplished with a fetal electrode, which is a spiral wire placed directly on the fetal scalp or other presenting part. Fetal heart rates by EFM are described in terms of base-line rate, variability, presence of accelerations, periodic or episodic decelerations, and the changes
Read more