Акушерство и геникология - Бекманн Ч.Р.
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CVS / AMNIS / MSAFP GLUCOSESCR EEN/RhIG
Рисунок 5.2A. Стандартизированная форма дородового наблюдения. 2 лист, 1 страница.
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GUIDENLINES: EDUCATION AND LABORATORY
INITIAL LABS DATE RESULT REVIEWED COMMENTS/ADDITIONAL LAB
BLOOD TYPE / / А В AB 0
RH TYPE / / + /-
ANTIBODYSCREEN / / -/*
HCT/HGB / / % am/dl
PAP SMEAR / / NORMAL /ABNORMAL/
RUBELLA / / • -/ +
VDRL / / -/ +
GC / / -/ +
URINE CULTURE / SCREEN / / -/ +
HBSAG / / -/ +
8-18 WEEK LABS DATE RESULT
(WHEN INDICATED)
ULTRASOUND / /
MSAFP / / MOM
AMNIO/CVS / / -/ +
KARYOTYPE / / 46. XX OR 46. XY/OTHER
ALPHA-FETOPROTEIN / / NORMAL_ ABNORMAL_
24-28 WEEK LABS DATE RESULT
(WHEN INDICATED)
HCT/HGB / / % am/dl
DIABETES SCREEN / / 1 HR.
GTT (IFSCREEN ABNORMAL) / / _FBS _1 HR. _2 HR. _3HR.
RH ANTIBODYSCREEN / / -/ +
RhIG GIVEN (28 WKS) / / SIGNATURE
32-36 WEEK LABS DATE RESULT
(WHEN INDICATED)
ULTRASOUND / / -/ +
VDRL / / -/ +
GC / / -/ +
HCT/HGB / / % am/dl
OPTIONAL LABS DATE RESULT
(HIGH RISK GROUPS)
HIV / /
HGB ELECTROPHORESIS / / AA AS SS AC SC AF
CHLAMIDIA / / -/ +
PLAN / EDUCATION ГК/RAW MFAT1 COUNSI ELED riON COUN SELED
TOXOPLASMOSIS PRECAUTIONS (CA1 YES NO YES NO
CHILDBIRTH CLASSES TUBAL STERILISA1
VBAC COUNSEUNG
РНУЯІГДІ ACTIVITY CIRC' IMRfUSinN
PREMATURE LABOR SIGNS TRAVEL
NUTRITION COUNSEUNG REQUESTS
METHOD OF ANESTHESIA
BREAST OR BOTTLE FEEDING OTHER
