Rh negative case

1. Examination
of Rh negative pregnancy
Taruna
19112

2. GENERAL PHYSICAL EXAMINATION
• Patient is calm, conscious, cooperative, well
oriented to time place and person.
• lying comfortably on bed.

3. VITALS
• Pulse-
74/min, regular, good volume, no radioradial and
radiofemoral delay, all peripheral pulses present, vessel
wall not palpable.
• Respiratory rate-
16/min abdominothoracic.
• B.P.-
122/76mm of Hg, right arm, supine position by
auscultatory method.
• Patient is afebrile to touch.

4. ANTHROPOMETRY
• Weight before pregnancy –49kg
• Weight after pregnancy –59kg
• Weight gain during pregnancy –10 kg
• Height-5’’2
• BMI-23.94 kg/m2

5. • Pallor- absent
• Icterus- absent
• Cyanosis- absent
• Clubbing- absent
• Lymphadenopathy- absent
• Pedal edema- absent
• JVP- not raised

6. HEAD TO TOE EXAMINATION
• Head, hair, scalp, face- within normal limits.
• Eyes- normal vision, pupils reactive to light, no discharge.
• Ears, nose- within normal limits.
Oral cavity examination –
• No angular stomatitis and glossitis
• No cheilitis
• No foci of infection
• No dental caries
• Tonsils are normal
Thyroid Examination –
Thyroid is non palpable

7. • Breast Examination –
• Bilaterally symmetrical
• . No cracks/ fissures
• . No retraction or dimpling
• . Nipples and areola are healthy
• . No change in colour of overlying skin
• . No dilated vessels
• . No mass palpable

8. • Chest-
symmetrical, moving symmetrically with respiration, no scar
marks.
• Abdomen –
no scar marks ,normal Bowel sounds present.
• Extremities-
within normal limits.

9. SYSTEMIC EXAMINATION
• CVS-
within normal limits, S1 and S2 heard with no added
sounds.
• Respiratory system-
normal vesicular breath sounds heard. No added sounds.
• CNS-
within normal limits.
• GIT-
within normal limits.

10. OBSTETRIC EXAMINATION :
INSPECTION
• Size- enlarged.
• Shape- globular.
• Umbilicus- central and everted.
• Linea nigra and striae gravidarum seen.
• Flanks does not appear to be full.
• no venous prominence or visible pulsation.
• Hernia orifices- normal.

11. PALPATION
• Local rise of temperature- none
• Tenderness- none
• Abdominal girth-70cm.
• Fundal height- 28 weeks.
• Symphysio fundal height- 28cm.
• Fetal height corresponds to the period of
gestation.
• Uterus is relaxed and non tender.

12. OBSTETRIC GRIPS
• Fundal grip-
soft, broad, non- ballotable mass felt, suggestive of breech.
• Lateral grip-
smooth, hard, resistant surface felt on right side, suggestive
of back. Small , irregular, knob like structures felt on left
side suggestive of limbs.
• 1st Pelvic grip-
smooth ,hard ballotable mass suggestive of head.
• 2nd Pelvic grip-
approximation of fingers, suggesting no engagement of
head.

13. AUSCULTATION
• Fetal heart sound- present
• Site- right spinoumbilical line
• Rate- 142/min.
• Rythym- regular.

14. SUMMARY
⚫28 years old patient with G3 P2+0+0+1 with
gestational age of 28 weeks and a single live
fetus in cephalic presentation,uterus relaxed,
fetal heart sounds present with heart rate of
142/min at right spinoumbilical line. is Rh
negative female with history of delivery of baby
having anemia and jaundice during her second
pregnancy who died after 10 days of birth.