The first visit to a gynecologist during antenatal care, which is also known as the booking visit is an important day for a pregnant woman. As a woman who is expecting a child, it is important that you know what questions a gynecologist asks on your first visit. During the first visit, the gynecologist will focus on identifying the fitness of the woman for pregnancy and the risk of developing pregnancy-associated complications. The doctor will ask the questions and fill a pregnancy record for every woman on her first visit.
Questions Asked By Gynecologists On Your First Visit
Questions Asked By Gynecologist On Personal Details
- The doctor will initially identify the personal details of the mother including her name, age, address, and marital status.
- The number of previous pregnancies and the number of living children will be asked.
- All previous conceptions including the ones which have ended up in miscarriages or stillbirths will be included in the number of previous pregnancies.
- The date of the last regular menstrual period will be inquired from the woman to calculate the period of amenorrhoea or gestation and the expected date of delivery.
- The upcoming visits and the antenatal care will be decided on this date of delivery until the date is confirmed ultrasonically.
- The woman is then asked whether the pregnancy is a planned one or not and whether she has taken folic acid tablets prior to conception or not. This will give the doctor an idea about the risk of the fetus developing neural tube defects.
Questions Asked By Gynecologist On Previous Pregnancies History
- Among what questions a gynecologist will ask on your first visit, details regarding the previous pregnancies play a major role.
- Regarding the successful pregnancies, the birth year with the birth weight of the children and their wellbeing will be asked.
- Every single complication that has occurred during the previous pregnancies are noted. They include gestational diabetes mellitus, pregnancy-induced hypertension, preeclampsia, polihydroamniosis, fetal growth retardation, and other medical disorders.
- Then the postpartum complications are also asked about, like the presence of postpartum hemorrhage and fever. The mode of delivery is also an important fact in this part of history.
- The number of normal vaginal deliveries and the number of lower segment cesarean sections are noted.
- In case of a past c-section the clinician should assess the patient whether she needs to undergo another c-section or whether she is suitable for vaginal delivery in the current pregnancy. The importance of knowing about the miscarriages and stillbirths is that the doctor can identify recurrent miscarriages and possibilities of a woman having an antiphospholipid syndrome or lupus.
Questions Asked By Gynecologist About Past Medical History Of The Mother
- Past medical history of the mother also comes under what questions a gynecologist asks on your first visit.
- In this part, the mother is asked whether she is suffering from type 1 or type 2 diabetes mellitus, hypertension, kidney disease, thyroid disorders, heart diseases, and epilepsy etc.
- If the woman has diabetes mellitus the control of the disease and the possibility of the woman having micro or macrovascular complications of DM is asked.
- If the patient has stage 4 or 5 diabetes-induced nephropathy the pregnancy is usually not recommended. Because the pregnancy might worsen the function of the kidneys furthermore. In addition, knowing about the glycaemic control of the woman is also important to analyze the risk of the fetus developing congenital anomalies.
- If the pregnant woman has chronic hypertension, she is at increased risk of developing preeclampsia and fetal growth retardation.
- If the woman has heart disease, she should be referred to a cardiologist to assess the fitness to continue with the pregnancy. Because there are some heart defects like outflow obstructing heart diseases, which can get worse by pregnancy.
- Women with epilepsy need special care liaising with physicians or neurologist to decide about her antiepileptic drug regimen because most of them are teratogenic.
Questions Asked By Gynecologist On Mother’s Gynecological And Surgical Histories
- The next part of the questions will be focused on the mother’s gynecological and surgical histories.
- She is asked about the history of subfertility, fibroids, and previous gynecological or general surgeries.
- The mother will then be inquired about the drugs she is currently on as the next question asked on the first visit. There are many drugs which are not safe to be used during pregnancy, as they can cause teratogenicity.
- Examples of such drugs include angiotensin receptor blockers, statins, warfarin, etc. Those drugs should be immediately stopped and alternatives should be started. As the last component of the questions, some information regarding the woman’s family will be asked. This is also to identify the risk of the woman developing pregnancy-related complications.
Questions On Complete System Examination
- Other than the history taking, the gynecologist will do a complete system examination to exclude relevant findings important for pregnancy.
- The weight and the height of the woman will be measured and the BMI is calculated.
- The presence of clinical pallor will be noted along with the presence of jaundice to exclude the presence of any liver pathology.
- Then signs of nutritional deficiencies will be looked in the woman. Then the presence of pedal edema and varicosities will be noted.
- Blood pressure and the pulse rate is an essential part of the cardiovascular system examination which will help to detect chronic hypertension in the woman.
- Then the precordium will be auscultated to detect any murmurs which will suggest unidentified cardiac pathology.
Gynecological Tests Done On First Visit
- There are several investigations, which are done on the booking visit. The woman is expected at her first visit to give blood samples for a full blood count to see the hemoglobin level, blood group, HIV status, syphilis status.
- In addition, she is expected to give a blood sample 2 hours after her last meal to measure the postprandial blood glucose as a screening test to identify the presence of type 2 DM.
- She is also expected to get her urine sample tested for urine full report and for proteinuria.
- On her first visit, she will be advised to get instant consultation with a gynaecologist if she develops per vaginal bleeding with clot passage and if she develops or contacts a person with chickenpox and is not immune to it.
A comprehensive antenatal care program is carried in all countries globally to improve the outcome of pregnancy and to reduce the maternal mortality rate.
The booking visit is a crucial visit to this programme and it addresses most of the important problems in pregnancy. It is beneficial for pregnant woman to know about what questions do gynecologists ask on your first visit during your antenatal care.
Along with the information gathered from those questions, examination, and investigations, the future follows up will be made as an individualized plan to each and every pregnant woman since every woman is considered as a new mother.
Latest posts by Dr. Chathuri Weerawardana (see all)
- Right Time To See An Endocrinologist For Weight Gain - March 27, 2019
- What Questions Do Gynecologists Ask on Your First Visit? - March 11, 2019