MENORRHAGIA-------HISTORY TAKING

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

o Cycle length and frequency, e.g. 5/28, 5 days of bleeding every 28 days.
o How heavy is the bleeding? Number of tampons per day/clots/flooding/double
protection.
o Any intermenstrual bleeding (IMB).
o Any postcoital bleeding (PCB).
o Age of menarche/menopause.
o Any postmenopausal bleeding (PMB).
o Any pain during/after periods
o Any abnormal vaginal discharge
o Any weight gain/loss,lethargic/cold intolerance
o Any scan done before
o Contraception
o 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 occurs—around menstruation or around day 14 –

 Consider physiological

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

  Thin watery-----bacterial vaginosis

 Odour—fishy 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