MENORRHAGIA-------HISTORY TAKING

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Last menstrual period (LMP) - date of first day of bleeding.

Cycle length and frequency, e.g. 5/28, 5 days of bleeding every
28 days.
How heavy is the bleeding? Number of tampons per
day/clots/flooding/double protection.
Any intermenstrual bleeding (IMB).
Any postcoital bleeding (PCB).
Age of menarche/menopause.
Any postmenopausal bleeding (PMB).
Any pain during/after periods
Any abnormal vaginal discharge
Any weight gain/loss,lethargic/cold intolerance
Any scan done before
Contraception
Easy bruisibility

POST MENOPAUSAL BLEEDING

-----HISTORY TAKI

Any exogenous oestrogens taken.

Use of Tamoxifen .
History of PCO
Ovulation induction drugs
Family history of Hereditary non-polyposis colorectal carcinoma.
Obesity
diabetis
Use of combined oral contraceptives decreases risk
Any trauma
Any bleeding disorder
Vaginal atrophy symptoms
Duration of bleeding
Amount of bleeding
Duration of menopause

STERILIZATION----COUNSELING

Age
Married for
Parity
LMP
Stability of the relationship
Discussion about reversible methods of contraception
Female sterilization
Procedure

Stress on word irreversible

Done under G/A (complications of G/A)
Procedure related complications( bleeding,infection,damage to
gut,ligation of round
Ligament)
Failure rate (1 in 200)
Risk of luteal phase pregnany
Risk of etopic pregnancy
Male sterilization
outdoor procedure
done under L/A
no complications usually
failure rate 1in 2000

male sterilization preferred over female sterilization

HISTORY TAKING IN RECURRENT MISCARRIAGES

Maternal and paternal age

Ethnicity

Occupation

Consanguinity

Type of miscarriage

The gestational age at which the miscarriage occurred

How the diagnosis of miscarriage was made

Findings on ultrasound scan, if it was used

Details regarding how the miscarriage was managed

Results of any fetal karyotype performed.

IF ANY ALIVE BABIES THEN

Gestational age at birth

Complications during pregnancy and delivery

Mode of delivery

Weight of the baby

Current condition of the baby.

Gynaecology history should include:

Complete menstrual history, including last menstrual period, cycle

length, regularity of cycle, and symptoms of intermenstrual bleeding
Cervical smear history and any previous treatment for abnormal
smears, such as large loop excision of the transformation zone (LLETZ)
or cone biopsy

Contraceptive history, such as the method, duration of use, and

adverse effects (if relevant)

History of previous pelvic inflammatory disease

History of any infertility treatment (e.g., ovulation induction or assisted

conception

The medical history should particularly include:

Inquiry about the presence of autoimmune disease, arthritis, diabetes,

thyroid dysfunction, vascular thrombosis, and skin disorders
A family history regarding the medical conditions mentioned above
A family history of congenital abnormalities, recurrent miscarriage, or
pregnancy complications

The surgical history should focus on:

Previous abdominal surgery

Cervical surgery (e.g., knife cone biopsy) or uterine surgery (e.g.,
hysteroscopic septal resection or myomectomy)

The number of surgical uterine evacuations performed as the

management option for previous miscarriage.

Last of all inform the patient that still 70 perent chance of having a
baby
VAGINAL DISCHARGE ---HISTORY TAKING

Age of the patient

When do it occursaround menstruation or around day 14

Consider physiological

Consistency --thick,curdy-----candidiasis (ask about OCPs/diabetis)

Thin watery-----bacterial vaginosis

Odourfishy smell----bacterial vaginosis

o Foul smelling discharge--PID

Colour white candidiasis

o Transparent---bacterial vaginosis
o Green -----trichomoniasis

Ask about IUCD------ actinomycosis

Any lower abdominal pain,backache fever,-----PID

Any related menstrual problem

HISTORY TAKING IN INFERTILITY

FEMALE
Age
Duration of marriage
Marital history
Ist marriage of both partners
Cousin marriage
Type of infertility
Duration of infertility
Any history of contraception
Any history of weight gain/weight loss
Element of PCO
Element of hyperprolactinemia
Any thyroid problem
Autoimmune disorders
Cervical factors(d&c,amputation of cervix,cauterization)
Uterine factor( any surgeries,IUCD)
Tubal factor(ectopic pregnancy,pelvic T.B,BTL)
Any history of radiation/chemotherapy

MALE
Age
any autoimmune disease
Ist marriage
diabetis

Occupation
Habbits
Any previous surgeries
Any chemo/radiotherapy