The date of birth of the last live If applicable, enter the month and 1st Prenatal Care Record under: DOB Date of birth – born infant. year of birth of the last live born Pregnancy history information date infant. Include live born infants – now living and now dead. Previous OB history date – Past pregnancy history – Unknown portions of the date date should be entered as If the “99”. entire date is unknown mark the 2nd Admission H&P Unknown box. 12. Number of other pregnancy outcomes Definitions Instructions Sources Key words/Abbreviations Total number of other pregnancy Include all previous pregnancy 1st Prenatal Care Record under Miscarriages outcomes that did not result in a losses that did not result in a live Gravida section Fetal demise – “A” (abortion/miscarriage) live birth. birth. AB - Abortion induced Para section - EAB-Elective abortion “A” Includes pregnancy losses of any If no previous pregnancy losses Pregnancy history SAB - spontaneous abortion information - gestation age. mark TAB - therapeutic abortion ‘0’. complications Septic abortion Examples: spontaneous or induced For multiple deliveries: Previous OB history Ectopic pregnancy comments, complications losses or ectopic pregnancy. Include all previous pregnancy Tubal pregnancy losses before this infant in this Past pregnancy history FDIU fetal death in-utero – complications pregnancy and in previous IUFD intrauterine fetal – death/demise pregnancies. 2nd Labor and Delivery Nursing Admission Triage Form 3rd Admission H&P 13. Date of last other pregnancy outcome Definitions Instructions Sources Key words/Abbreviations
The date of birth of the last live born infant. If applicable, enter the month and year of birth of the last live born infant. Include live born infants now living and now dead. Unknown portions of the date should be entered as “99”. If the entire date is unknown mark the Unknown box. 1st Prenatal Care Record under: Pregnancy history information – date Previous OB history – date Past pregnancy history – date 2nd Admission H&P DOB – Date of birth 12. Number of other pregnancy outcomes Definitions Instructions Sources Key words/Abbreviations Total number of other pregnancy outcomes that did not result in a live birth. Includes pregnancy losses of any gestation age. Examples: spontaneous or induced losses or ectopic pregnancy. Include all previous pregnancy losses that did not result in a live birth. If no previous pregnancy losses mark ‘0’. For multiple deliveries: Include all previous pregnancy losses before this infant in this pregnancy and in previous pregnancies. 1st Prenatal Care Record under Gravida section – “A” (abortion/miscarriage) Para section - “A” Pregnancy history information - complications Previous OB history complications Past pregnancy history complications 2nd Labor and Delivery Nursing Admission Triage Form 3rd Admission H&P Miscarriages Fetal demise AB - Abortion induced EAB-Elective abortion SAB - spontaneous abortion TAB - therapeutic abortion Septic abortion Ectopic pregnancy Tubal pregnancy FDIU – fetal death in-utero IUFD – intrauterine fetal death/demise 13. Date of last other pregnancy outcome Definitions Instructions Sources Key words/Abbreviations comments,
Guide_MPM_BC_Facility_Worksheet_Guidelines.10.14.docx