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Prenatal questionnaire form 2025

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The document is a comprehensive prenatal questionnaire designed to gather essential information from expectant mothers. It includes sections on personal details, menstrual history, past pregnancies, personal and family medical history, genetic history, and infection history. The aim is to assess the health status of the mother and any potential risks for the pregnancy.

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What questions should I ask for prenatal history?

Did you have any problems during your previous pregnancies such as hypertension, gestational diabetes, seizure disorder, hyper/hypothyroid that required medication management or frequent lab work? Are your children healthy or do they have any long-term problems that require ongoing medical management?

What family medical history should I know for pregnancy?

Tell your doctor if you have any family members with a genetic condition, chromosomal abnormality, developmental disability, birth defect, newborn screening disorder, or other problem at birth or during infancy or childhood, especially if you have had a previous pregnancy or child affected by one of these conditions.

What is the pregnancy activity questionnaire?

Pregnancy Physical Activity Questionnaire. The PPAQ is a semiquantitative instrument that measures duration and intensity of time spent in household/caregiving, occupational, transportation, and sports/exercise activities (6).

What should be included in prenatal history?

Overview Your menstrual history. Your reproductive history. Health problems in your family, such as heart disease or genetic conditions. Your general health. Any medicines you take regularly. Any habits that could affect your pregnancy, such as tobacco, alcohol, or drug use.

What is a normal prenatal assessment?

One of the goals of your first visit to the obstetricians office is to confirm your pregnancy and see whether you or your baby could be at risk for any health problems. The doctor will do a full physical exam, which may include a weight assessment, blood pressure check, and breast and pelvic examination.

Which of the following are components of a prenatal history?

PRENATAL HISTORY Maternal history consists of information concerning past pregnancies, including complications, and specifics of labor and maternal illness, including infections and the use of alcohol or drugs [3].

What questions are asked on a pregnancy survey?

How many pregnancies have you had? Date of birth or end of pregnancy: How many weeks? What is the babys name? How much did the baby weigh?

What questions should I ask at first prenatal visit?

Questions to ask at your appointments How much weight should I gain? Are my prescription medications safe for pregnancy? Am I at risk for any complications or conditions? Which over-the-counter medications are safe? Which prenatal vitamin do you recommend? Which prenatal screenings do I need? Is it safe to exercise?

Prenatal questionnaire form 2025

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