Prenatal care record sheet

The core essence of the "Prenatal Care Record Sheet" is a dynamic risk prevention and control tool covering the entire cycle from 28 weeks of pregnancy to labor, rather than a standardized form-filling material only for hospital archiving. Clinical data from domestic tertiary obstetrics and gynecology hospitals show that a standardized prenatal care record sheet can reduce the incidence of adverse labor events in late pregnancy by more than 42%.

Last week, when I was attending the obstetrics clinic of our hospital, I met Sister Zhang, a 38-week pregnant mother of her second child. She rushed in with a prenatal check-up bag, her trouser legs were rolled up to her knees, her feet were swollen like steamed buns, and the record sheet in her hand was wrinkled like a pickle. I looked through it and found that her diastolic blood pressure had been above 95mmHg for three consecutive days. I didn't take it seriously and said, "I just haven't been able to sleep well recently. I thought it was normal." Fortunately, the community nurse turned over her record sheet when she came to the door the day before and forced her to come to the hospital. She was found to have mild preeclampsia and was admitted to the hospital the same day. If it were delayed a week later, she might have convulsions, which is dangerous for both adults and children.

Many people have a really deep misunderstanding of this record sheet. I have seen many pregnant mothers take out the form half an hour before each prenatal check-up and fill it out blindly. They only fill in the weight from the last time and write down seven or eight fetal movements. The question is, "I have been busy recently and forgot to remember it. Anyway, every prenatal check-up is normal. Filling this out is just a formality." Some family members followed suit and said, "If you don't have time to fill out the form, why don't you make more soup for her." It's really helpless.

There are actually disagreements in the obstetrics circle about the dimensions of filling in this record sheet. One group is the "minimalist" group, mainly obstetricians in public general hospitals who hold this view. They feel that pregnant mothers have limited energy and there is no need to put too much burden on them. They just remember four core data: daily morning fasting blood pressure, weight, the number of fetal movements in the morning, noon and evening, and the frequency and duration of contractions. If it is enough, it will be easy to miss and make mistakes if it is too much. The other school is the "all-dimensional school", which is mostly supported by private obstetrics and gynecology hospitals and researchers who specialize in maternal-fetal medicine. They believe that daily dietary intake (especially the amount of sugar and salt), sleep duration, emotional state, and even the characteristics of secretions should also be added. Many hidden problems, such as blood sugar fluctuations in gestational diabetes and early signs of intrauterine infection, can be discovered from these detailed records. My own experience in following doctors for so many years is that there is no absolute good or bad. If you are a low-risk pregnant mother who is younger than 35 years old, has no underlying diseases, and every prenatal check-up goes smoothly, the simplified version is completely sufficient. If you are an older person, a high-risk group with a history of gestational hypertension/diabetes, or a previous adverse pregnancy history, it is better to try to remember as much as possible, there is no harm.

Speaking of which, there are really a lot of people who get into trouble when filling out the form. For example, when it comes to fetal movement counting, 90% of pregnant mothers fill it out incorrectly at first, thinking that every movement counts as one, but in fact, all continuous movements within 5 minutes count as one. I met a pregnant mother last month who recorded 18 fetal movements/12 hours for three consecutive days. According to the standard, she met the standard. However, I saw that her numbers were too round every time. I asked her to sit and count for an hour, only to find that she counted every kick of the baby, which came out to 22 times in an hour. In actual calculation, it was only 3 times. During the B-ultrasound that day, it was found that the umbilical cord was wrapped around the neck for two weeks. Fortunately, it was discovered early and the fetal heart rate was monitored every day. In the end, the birth went smoothly. There is also the measurement of blood pressure. Many people take it just after climbing the stairs or after eating. The value is definitely inaccurate. You have to sit down and rest for 10 minutes before taking the measurement. The position of the cuff should be at the same level as the heart. If you don’t pay attention to these small details, the numbers filled in will be useless. It is better not to fill in the blood pressure at all.

You really don’t have to do it as if you’ve finished your homework. I've seen many pregnant mothers print out the record sheet and stick it on the refrigerator door. They fill it in easily after drinking water in the morning, taking blood pressure and weight, and counting fetal movements while sitting on the sofa watching TV after dinner in the evening. Their husbands help fill in the form next to them, and they pay more attention to it than memorizing it themselves. Some even use their mobile phone memo to make a simple form and fill it out on the way to work. It's not that troublesome. Oh, yes, many hospitals now have automatically synchronized records in their electronic prenatal examination systems. If you fill in the values ​​at home, the doctor can see them directly. If you have any questions, he can call you directly, saving you a trip.

A while ago, I was sorting through old cases in the department, and I turned over a prenatal care record sheet from ten years ago. The values ​​on the front were filled in neatly, and on the back there were crooked words: "Today, the little guy kicked me three times. I happened to be eating strawberries. Maybe he is a greedy little cat." You see, to put it bluntly, this thing is not only a talisman to protect you from risks, but also a small souvenir before you meet the little one for the first time. It never hurts to have some snacks while filling it out.