OBGYN – Prenatal Chart Review

[text name="name" default=""]
[text name="age" default=""]YO G[text name="gest_prior" default=""]P[text name="preg_prior" default=""] at [text name="currentgest_weeks" default=""]w[text name="currentgest_days" default=""]d here for [text name="cc" default="reason"]
HPI: 
[textarea name="hpi" fillable="" default=""]

[checklist name="routine_check" value="fluid leakage|vaginal bleeding|contractions|are you feeling baby move|kick counts (10 kicks/2 hours)"]

PMH: [textarea name="pmh" fillable="true" default="***what conditions can affect pregnancy & what's been done so far*** ***prior surg***"]

OB Hx: [textarea name="ob_hx" fillable="true" default="***prior preg, weeks, vag or CS*** ***complications*** ***STIs***"]
[checklist name="ob_hxcomp" value="elevated BP needing Mg|blood loss needing transfusion|shoulder getting stuck"]

Meds: 
[textarea name="meds" fillable="" default=""]
[checklist name="meds" value="prenatal vitamins"]

Soc hx: [text name="soc_hx" default=""]
[checklist name="soc_drugs" value="smoking|drinking|other drugs (note in PMH)"]

Fam hx: [text name="fam_hx" default=""]
[checklist name="fam_cancers" value="breast|colon|endometrial|ovarian"]

Labs: 
[textarea name="Labs" fillable="" default=""] 
[checklist name="gyn_check2" value="abnormal pap|pelvic US findings|mammogram"]
Initial H&P: 
[checklist name="init_hp" value="blood type, Rh, Ab screen|CBC (anemia)|rubella|varicella|hepB|syphilis|HIV|GC/chyla|urine protein|urine culture|pap smear|GDM 1-hr (if high risk)"]
1st tri (0-13w): 
[checklist name="1_tri" value="NIPT OR first semester combined - NT, hCG, PAPP-A (10-13w)|cfDNA (10w+)|CVS (10-12w)|carrier"]
2nd tri (14-26w): 
[checklist name="2_tri" value="quad screen - hCG, AFP, estriol, inhibin-A (15-20w)|amniocentesis - age 35+; abnormal NT, quad, NIPT; Rh-sensitized (15-20w)|fetal anatomy survey (18-21w)|short cervix|GDM 1- or 3-hr (24-28w)"]
3rd tri (27-40w): 
[checklist name="3_tri" value="TDaP (27-36w)|repeat type & screen and give Rhogam if Rh(-) (28w)|GBS (36w)|ECV if breech|depression"]
Imaging: 
[textarea name="imaging" fillable="" default=""] 

Ddx: 
[textarea name="ddx" fillable="" default=""]

Plan: 
[textarea name="plan" fillable="" default=""] 

Other: 
[textarea name="other_notes" fillable="" default=""]