14. Risk factors in this pregnancy Definitions Instructions Sources Key words/Abbreviations 1st Prenatal Care Record under IUGR intrauterine growth h - Other previous poor – pregnancy outcome or Medical history restriction (retardation) risk factors Previous OB history FDIU fetal death in-utero – under—summary of IUFD-Intrauterine fetal death History of pregnancies previous pregnancies SGA small for gestational – Problem list or—initial continuing into the 20th week age risk assessment of gestation and resulting in SFD small for dates – Historical risk summary Stillborn- infant/fetus born of any of the listed outcomes: Perinatal death (including Complications of without any gestational age previous pregnancies signs of life fetal, stillbirth and neonatal deaths Small for gestational age 2nd Labor and Delivery Nursing Look for: PROM premature rupture of Admission Triage Form – birth membranes under Comments. – PPROM preterm premature – 3rd Admission H&P under rupture of membranes Previous OB history Additional risk factors under—pregnancy related Cervical procedures (cervical Complications Previous cone biopsy or conization) Pregnancies LEEP (loop electrical excision Problem list/findings procedure) D&C dilation and curettage – Bleeding after 14 weeks Uterine anomalies
14. Risk factors in this pregnancy Definitions Instructions Sources Key words/Abbreviations h - Other previous poor pregnancy outcome or risk factors History of pregnancies continuing into the 20th week of gestation and resulting in any of the listed outcomes: Perinatal death (including fetal, stillbirth and neonatal deaths Small for gestational age birth Additional risk factors Cervical procedures (cervical cone biopsy or conization) LEEP (loop electrical excision procedure) D&C – dilation and curettage Bleeding after 14 weeks Uterine anomalies 1st Prenatal Care Record under Medical history Previous OB history under—summary of previous pregnancies Problem list or—initial risk assessment Historical risk summary Complications of previous pregnancies 2nd Labor and Delivery Nursing Admission Triage Form under – Comments. 3rd Admission H&P under Previous OB history under—pregnancy related Complications Previous Pregnancies Problem list/findings IUGR – intrauterine growth restriction (retardation) FDIU – fetal death in-utero IUFD-Intrauterine fetal death SGA – small for gestational age SFD – small for dates Stillborn- infant/fetus born of any gestational age without signs of life Look for: PROM – premature rupture of membranes PPROM – preterm premature rupture of membranes
Guide_MPM_BC_Facility_Worksheet_Guidelines.10.14.docx