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''Dossier'' of the expectant mother. What is a ''exchange card''? Why do I need an exchange card during pregnancy

O The exchange card is the main source of information about the course of pregnancy. How to decipher medical terms, what do they mean? What notes on the exchange card should you pay special attention to? You will learn the answers to these and other questions by reading the Passion.ru article.

An exchange card is an important document for a pregnant woman. The information indicated in it allows the doctor to objectively assess the state of your health and choose the tactics of conducting childbirth.

The exchange card consists of three parts - the first is filled out by a gynecologist in the antenatal clinic, the second - by the doctor who will take delivery, the third - by the neonatologist of the maternity ward.

This document does not replace a medical record, but allows each specialist a woman contacts to receive up-to-date information about the course of pregnancy and its features, and, if necessary, supplement it.

Exchange card: the course of pregnancy

The first part of the exchange card is filled in by a doctor from the antenatal clinic. Information about the state of health of the pregnant woman is entered into the card based on the examination and test results.

Be sure to indicate all transferred infectious diseases, the presence of chronic diseases.

For example, an insidious infectious disease - - it is dangerous during pregnancy. If you have already had this disease in childhood, then you should not worry - you have developed lifelong immunity and re-infection does not threaten.

A big problem is the incidence of rubella in early pregnancy. The risk of congenital malformations in the fetus is very high - cataracts, deafness, open ductus arteriosus.

That is why it is so important to enter all this information into the exchange card - in case of trouble, the doctor will be able to choose the right tactics for managing your

Important information about previous pregnancies and childbirth, if any.

For example, if in a previous pregnancy you had there is a risk of recurrence of complications during subsequent pregnancies.

Was there a premature birth or an urgent, vaginal delivery or caesarean section - all this is also important for the doctor who manages your pregnancy.

If previous births were difficult, or an emergency caesarean section was required, then this will require additional examinations.

risk factor for pregnancy

Their number and the gestational age at which artificial interruption was performed is reflected in the exchange card.

The first day of the last menstrual period is indicated.

From this date, it is customary to count the gestational age. The estimated date of delivery (EDD) is calculated as follows - by the first day of the last menstruation, you need to add 7 days and subtract 3 months. There is another way - to the first day of the last menstruation, add 280 days (40 weeks).

The date of the first appearance is indicated - the day when you will be officially registered in the antenatal clinic.

It is advisable to register before 12 weeks of pregnancy. Firstly, this is necessary in order to minimize possible complications. After all, the first trimester is the most important period of pregnancy, the laying of all the organs of the fetus takes place, and a doctor's observation will not hurt.

And secondly, women who are registered before 12 weeks are entitled to a separate cash allowance.

The exchange card also contains many other information: the date of the first the size and position of the fetus in the uterus, the results of ultrasound.

At 11-12 weeks Ultrasound is part of the screening of the first trimester - the coccyx-parietal size of the embryo (CTE) is measured, the thickness of the collar space is estimated (this is an important indicator, which, together with a blood test taken at the same time, allows you to calculate the risk of fetal chromosomal abnormalities).

At 20-24 weeks it is already possible to consider the anatomical structure of the internal organs of the fetus, determine if there are any malformations, assess the location and thickness of the placenta, the nature and amount of amniotic fluid.

At 34-36 weeks the doctor looks at the location of the fetus in the uterus (head or breech presentation), assesses the size of the fetus, the condition of the placenta - this is the necessary information to determine the tactics of the upcoming birth.

In addition, the exchange card must contain the conclusions of other specialists: an ophthalmologist, dentist, therapist, otolaryngologist.

For example, if there are pathological changes in the fundus and retina, then the ophthalmologist gives recommendations on excluding the straining period. The otolaryngologist evaluates the condition of the pharynx and larynx - this is important for anesthesia during caesarean section.

Exchange card: childbirth and the postpartum period

The second part of the exchange card is filled in the maternity hospital. The map contains information about how and early postpartum period. At discharge, this part is given to the woman in her arms so that she can transfer it to the antenatal clinic for follow-up.

So, what should be included in the card in the maternity ward?

The most important thing is the date of birth. This is necessary for issuing a birth certificate for a child, for issuing an additional sick leave (if there were complicated births).

Features of the course of childbirth.

The duration of labor, the duration of the anhydrous period, complications in the mother and fetus are indicated. This information is important for predicting the course of the postpartum period.

The use of operational aids in childbirth.

The Apgar scale is a sum of points that assesses the state of functioning of the organs and systems of a newborn at 1 and 5 minutes of life.

Points

color of the skin pale bluish limbs pink, red breath absent slow, uneven good, loud crying heartbeat absent less than 120 bpm more than 120 bpm reflexes no slight grimace coughing, sneezing, screaming muscle tone missing limbs flexed actively moving parts of the body

The maximum score is 10. A child whose condition is estimated at 6 points or less needs resuscitation and subsequent intensive care.

The character is indicated newborn (breast, mother's expressed milk). It is indicated which mixture was used in the maternity hospital, whether there is an allergy to it.

It must be noted whether anti-tuberculosis vaccination was carried out, the first against hepatitis B (in the first 12 hours of life). If not, the reason is given.

Exchange card: memo for pregnant women

An exchange card is issued to a woman in consultation at the 28th-32nd week of pregnancy. Some paid medical centers can also issue exchange cards.

If there is a need for hospitalization in the department of pathology of pregnant women, then the card can be issued for a shorter period.

But to get an exchange card, you need to pass at least once and visit the doctor at least twice - for the initial examination and obtaining referrals for research and for the results of the tests to be entered into the exchange card and issued to you.

This document is essential for admission. From the moment you receive your exchange card from your doctor, try to keep it handy at all times.

Even if there is a month left before the birth, and you go to the supermarket for groceries or to visit a friend, put the card in your bag - no one can accurately predict when your baby will decide to be born.

Remember, if you do not have an exchange card when you register at the maternity hospital, then you will be placed in the infectious diseases department. And usually there are women with signs of serious illnesses.

This is quite reasonable - if the doctor does not have data that you are not a carrier of any infections in the first place - and syphilis, then you are at risk and need to be isolated from other women in labor.

But what to do if you suddenly lost your exchange card?

Don't worry, there is a way out. A duplicate of the document remains in the archives of the clinic, all information about the course of pregnancy is in the medical record.

Therefore, if you lose the original, you can present your passport and policy, and get a copy of the card at the antenatal clinic.

So, yesterday we discussed the need to maintain an exchange card and the nuances of filling it out, and today we will discuss with you point by point what and how to fill in an exchange card so that you yourself can evaluate and tell the doctor certain features of filling out your pregnancy documents. Accurate and detailed filling out of the exchange card is important so that the doctor can, after reading your card, get a complete picture of you - how is your health, what difficulties can you expect during pregnancy and how the birth will be planned - natural or by caesarean section. All this can be understood with the correct filling of documents and communication with the patient.

Filling out an exchange card with a women's consultation.

In the antenatal clinic, the first part of the exchange card is filled out, which indicates information about the woman and the course of her pregnancy, in a special order. Let's see how doctors fill out the card, what needs to be indicated and why.

First of all, the doctor fills in your passport data - first name, patronymic and last name, it is important to indicate the exact age, since very young women in childbirth under 18 years of age and older women in labor after 35 years of age more often than usual may have problems during pregnancy. The exact address will also be indicated both by registration and by actual residence - this is necessary for emergency cases, if a woman in labor (or her relatives) needs to be quickly found, but she does not answer the phone. Usually, the woman’s phone number is also indicated - home and cell, as well as close relatives - usually her husband, for emergency communication if necessary.

Further, data on the woman's diseases, both general (pyelonephritis, bronchitis, sinusitis), and gynecological operations, are entered into the card. It is especially important to identify hereditary and chronic pathologies, since they can have the most adverse effect on the course of pregnancy, the correct development of the fetus and the course of childbirth. It is even important what diseases a woman suffered in childhood, because with rickets the pelvic bones can be deformed, which will significantly complicate childbirth, in the absence of indications of childhood infections, separation from patients will be necessary. If there are problems in a feminine way, during pregnancy and childbirth they can become aggravated, which leads to complications in pregnancy and childbirth.

Then you must complete the section on the course of previous pregnancies or childbirth, if this is not the first pregnancy. If any complications occurred in previous pregnancies and childbirth, then in the postpartum period, the doctor will have to more carefully monitor the current pregnancy in order to exclude the influence of negative factors and the tendency to various pathologies during early or late pregnancy. So, late or early toxicosis of pregnant women, threats of abortion, and the development of anemia during pregnancy are specific. If the past birth was pathological, it is necessary to carry out the prevention of complications of pregnancy and childbirth this time. You will need special supervision in the postpartum period.

It is indicated in the card what kind of pregnancy is on the account, and what kind of childbirth will be, how many children a woman has. Since it is important for predicting the course of pregnancy that not all pregnancies ended in childbirth, it is indicated whether there were abortions, in what year at what time, since after abortions there is a high risk of inflammatory processes in the area of ​​\u200b\u200bthe appendages or uterus, which can increase the risk of adverse the course of pregnancy this time and can lead to pathologies in childbirth. If earlier there were episodes of premature birth - then when and in what period it happened, what was the reason for their occurrence. This is necessary to prevent preterm birth at the same time.

Next, you need to indicate the period of the last menstruation, and indicate the first day of normal menstruation. This makes it possible to calculate the duration of pregnancy and the expected date of your birth. Next, the terms of pregnancy are indicated at the first visit to the doctor, this also helps to clarify the date of delivery and gives the doctor an idea of ​​\u200b\u200bhow to plan the pregnancy. The card also indicates the total number of visits to the doctor, since according to special medical orders there is a special plan for visiting a doctor and observing a pregnant woman. According to it, a woman with an uncomplicated or complicated pregnancy visits the doctor a strictly regulated number of times so that her examination and observation is complete.

If the pregnancy is proceeding normally, this will be ten visits to the doctor:

The first visit, then ten days later with the results of tests and examination by specialists, then the woman goes to the doctor once a month until 28 weeks, twice a month until 36 weeks, and then every seven to ten days until delivery.
- if pathologies or any threatening factors are detected, the terms for visiting a doctor are set for each woman individually. If necessary, the doctor prescribes additional tests.

It is necessary to indicate the timing of the first movement of the fetus, which is important to clarify the timing of childbirth, while the timing of the first movement in a woman with a first pregnancy differs from the timing of the one who gives birth again.

It is important to indicate all the features during this pregnancy, which could somehow affect further childbirth and will provide useful information to the doctor of the maternity hospital. Many complications during pregnancy can significantly affect the process of childbirth, the method of delivery, and further, the postpartum period.

First of all, you need to measure and accurately indicate all the dimensions of the pelvis, there are several of them. The pelvis can be narrow in one or more sizes if the numbers differ by 1.5-2 cm or more. With a narrowing of the size of the pelvis, there is a possibility that the fetus, when it grows up to the due date, may not pass through the birth canal. But there may also be birth canals of quite normal size, while the size of the fetus is high and creates a state of a relatively narrow pelvis - that is, relative to the child. The dimensions of the pelvis are specified several times during pregnancy, and they are also correlated with the dimensions of the head and body of the fetus, its weight.

Also, a woman’s weight and body proportions are measured, since with low stature there may be anatomical features of the spine and pelvis, which can cause a clinically narrow pelvis and cause difficulties in bearing a child. It is important to measure the weight and fix it initially, since the final weight gain of the woman will be calculated from this weight, on average, the expectant mother can add from 10 to 15 kg, depending on the physique and initial weight at the first appearance. If a woman has a weight deficit for height, she can add up to 15-17 kg, if the excess is no more than 9-10 kg.

As the baby grows and develops, it is important to note the position that he occupies in the uterus. This factor is crucial during childbirth, since the most optimal for childbirth is the head presentation of the baby in a special position. With other presentations, the issue of delivery will be decided based on the specific position of the child in the uterus and the possibility of natural childbirth towards the end of the term. The fetus takes its final position in the uterus after 32-34 weeks, before this rock it can turn over several times. Pathological presentations are the oblique position of the fetus, transverse, facial, pelvic and others. But in 95% of women, by the time of birth, the babies are in the correct position in the uterus. If the fetus does not unfold by 32 weeks, this gives the doctor a reason to prescribe special methods of gymnastics for the woman so that the fetus turns over in the uterus into the desired position.

Next, the doctor determines the presenting part of the fetus - this is the part that stands in the pelvic area and will be the first to pass through the birth canal. With the head location of the fetus, the presenting part should be the occipital part, so the head will enter the pelvis in the smallest size. But it can also be the presenting face, forehead, crown. This is worse for childbirth and increases the risk of injury - the size of the head becomes not the smallest size in the pelvis. With a breech presentation, there may be an ass, legs with buttocks, or only legs. All these data are important for deciding on the management of childbirth - whether it will be a natural delivery or childbirth is best done through a caesarean section.

It is also important to note in the exchange card such indicators as the heart rate per minute in the fetus, determined by an obstetric stethoscope, which is applied to the abdomen and listened to. By the number of heartbeats per minute, the condition of the fetus is determined when it is comfortable in the mother's stomach: if the heart rate reaches 140 beats per minute and the rhythm is clear and precise. If the rhythm is disturbed, one can think of hypoxia, problems with the placenta, or any other complications. In the place where the heartbeat is heard more clearly, one can judge how the baby lies in the uterus - legs or head down. The heartbeat of the fetus in the exchange card begins to be recorded from 32 weeks, at each visit to the doctor, and the data is noted in the card.

Tomorrow we will fill out analyzes and observation diaries, as well as the second and third parts of the map.

Why an exchange card for a pregnant woman?

Carrying a child is a very important period during which constant medical supervision is required. All important points are recorded in the main document of a woman expecting a baby - an exchange card. It is conducted from the moment of registration to the very birth, helping doctors quickly find out all the features of the course of pregnancy. The completed exchange card is given to the doctor taking delivery.

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The need for an exchange card

Every expectant mother, having learned about her situation, should visit a gynecologist.

Pregnancy, although not a disease, requires increased attention to the health of a woman, especially at the initial stage.

It is during this period that the body has an increased load, and the timely detection of health problems allows you to avoid any risks to the fetus.

When registering, the expectant mother must pass many surveys:

  • take a large number of tests;
  • regularly attend scheduled examinations at the gynecologist;
  • visit some narrow specialists to exclude pathologies that affect the course of pregnancy and childbirth.

All data is recorded in medical records, but it can take time to find them. That is why there is a need to issue an exchange card for a pregnant woman, which contains all the basic data.

In case of unforeseen circumstances, this will allow doctors to quickly assess the features of the course of pregnancy and help the expectant mother.

What is an exchange card, a woman finds out almost immediately upon registration. The gynecologist informs about its need, and immediately enters the main data into it.

What is included in the card

At each appointment, the following is recorded:

  • weight to assess the development of pregnancy;
  • girth of the abdomen;
  • woman pressure.

All data is carefully entered into the card, which remains with the doctor and allows you to monitor the dynamics of not only the development of the fetus, but also the well-being of the expectant mother herself.

The patient herself should also know the main indicators, so that in case of deterioration of health or premature birth, she should be ready to answer all the questions of the medical staff.

That's what an exchange card is for, containing everything you need.

The exchange card must be kept in a neat manner avoid getting wet or damaging pages. It is better to purchase a cover, because you will have to carry it with you for quite a long period.

Features of the exchange card

An exchange card for a pregnant woman is a document that stores information about the expectant mother and the development of the fetus. Its design takes a lot of time, information is replenished at each appointment, creating an overall picture of the course of pregnancy. On the cover The following information is usually recorded:

  • date of birth and age;
  • address and contact phone number;
  • registration period;
  • medical policy number.

Depending on the medical institution in which the card is issued, the cover may contain other different data.

Everything important features women's health are indicated on the cover at the top. This is data on allergic reactions, problems in previous births and chronic diseases that affect the course of pregnancy and the process of labor.

On the first page, as a rule, indicate information about the spouse, place of work and possible harmful factors associated with work. The presence of bad habits and chronic diseases also fit in at the beginning. At the first appointment, the doctor necessary measurements: weight, height, pressure, abdominal circumference. All this is recorded during the execution of the document, the data is supplemented with information about the day of the last menstruation and information about the number of pregnancies.

Sample exchange card a pregnant woman is available in almost every antenatal clinic, but it is needed only for familiarization, since the doctor fills out the document. The expectant mother herself only checks the entered data, controlling the development of her baby. As the period increases, other required information:

  1. DA. This is the preliminary date of delivery, it is on her that doctors look when a woman enters the maternity hospital, to decide on subsequent actions. This date is approximate and serves as a guideline.
  2. Date . According to it, doctors determine the degree of development of the fetus, its activity and well-being.
  3. The results of all tests, ultrasound, screenings. Data is entered sequentially, allowing you to evaluate the dynamics and changes. Separately, an analysis is allocated for the blood type and Rh of the mother, for enhanced control in the event of the likelihood of a Rh conflict.
  4. Pelvis dimensions women and fetal position. This is very important data necessary to determine the method of delivery, and when the parameters of the expectant mother are far from the standards.
  5. Number of doctor visits. Necessary upon issuance, which is required upon admission to the hospital.

You should not correct the data in the map yourself, this can lead to confusion. After receiving the document in their hands, women no longer have questions about what an exchange card is and why it is pregnant. Storing important data in one place is convenient for both doctors and the patient herself.

Appearance of the exchange card

Before registration in the antenatal clinic, it is quite difficult to find out exactly what the document of interest looks like. The fact is that in every medical institution there is your option.

The basis is the same everywhere, the data is entered the same, only the appearance differs. Most often, these are just a few A4 sheets stapled together, on which fields are printed to fill out.

They always draw up a card, and regardless of its appearance, any doctor will see the information he needs.

Another common option is a booklet made from several sheets. A5 format.

When they give out an exchange card to a pregnant woman, a surprise can await the expectant mother: some medical institutions issue not just papers with data, but a real book in a beautiful cover. In this form, it is more pleasant to hold it in your hands, it wrinkles less and retains a decent appearance throughout the entire period.

Some shops for expectant mothers and babies have a good discount program for pregnant. It is valid upon presentation of an exchange card, so when going shopping, you should take it with you.

Terms and features of registration

When it comes to the main document of a pregnant woman, expectant mothers are interested in how she looks and when she is handed over. The terms of its registration have not been established, the doctor enters the data when registering or upon re-admission, when he receives the results of all tests. In most cases, filling in the data takes place in the presence of the expectant mother. The doctor or nurse interviews the woman, immediately entering information into the document. In some cases, the information available in the medical record is entered later.

The storage of the document causes controversy even among physicians, therefore, only the doctor who is pregnant can give information on how long a woman is issued an exchange card.

Refine information should already be at the first appointment, so that in the future there will be no confusion and loss of important information.

Most moms-to-be can't wait to have a completed exchange card in their hands.

It is quite a normal desire to know the test results and not worry about having to remember everything. Terms of receipt of the document are possible in two versions:

  1. At the time of registration. The most common option, since doctors do not always want to keep a huge amount of such documents. It is enough that they have a filling pattern.
  2. At the end first trimester, at 12 obstetric weeks. This is due to the fact that it is at this time that the first ultrasound takes place, the patient passes, showing a complete picture of the course of pregnancy. In addition, after 12 weeks it is already forbidden to terminate a pregnancy without medical indications, and the doctor calmly gives the document to the expectant mother.
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The document that the expectant mother needs always carry with you is an exchange card. Collected in a small book all information, which will help doctors determine the condition of a pregnant woman if she has premature labor or another critical situation has occurred.

Exchange card- This is a brochure in which the results of tests and the condition of the pregnant woman are written out. Losing the exchange card does not threaten anything. Her you can always refill. But the birth certificate is the only document that cannot be fully restored.

What is an exchange card?

In different cities and regions exchange card is different in appearance(size, beautiful design, etc.), but its content is the same for everyone.

Sometimes an exchange card looks like an ordinary book with forms to fill out, sometimes like a bright brochure advertising various vitamin preparations, or just printed A4 sheets.

In any case, the exchange card must always be carried with you. For this it is better to select a folder, where the card itself, and the birth certificate, and other important documents (for example, extracts from the hospital, photocopies of ultrasound, prescriptions and doctor's recommendations) will be enclosed in separate files.

When are they handed out?

An exchange card for a pregnant woman is already being issued on. According to various sources, the document is allowed to be handed out in the maternity ward for a period of, or. This is evidenced by the special Order No. 50 of February 10, 2003 "On the improvement of obstetric and gynecological care in outpatient clinics".

Such a restriction was introduced in order to monitor congenital malformations of the fetus, and termination of pregnancy will be regarded as premature birth.

What should be in the exchange card?

The exchange card consists of three parts coupons. Each coupon corresponds to a certain period of pregnancy or the postpartum period.

Part 1. Information from the antenatal clinic about the pregnant woman

first part the exchange card is filled in by a doctor from the antenatal clinic, where the expectant mother is being monitored. This coupon must include the following items:

1. Full name of the pregnant woman.

2. The age of the pregnant woman. This point is important, since early and late pregnancies can give certain complications.

3. Actual residential address- necessary in emergency situations, when you can contact a pregnant woman only through her relatives.

4. Operations (general and gynecological) that a woman had before pregnancy.

It also includes childhood, chronic and hereditary diseases.

5. Previous pregnancies and their features.

If during a previous pregnancy a woman had complications, then each subsequent pregnancy will be observed with special care. This is a necessary measure to prevent pathological conditions: early or late toxicosis, the threat of abortion, anemia, etc.

If during the previous birth a caesarean section was performed, then the subsequent ones will also take place in the same way.

6. Data on previous pregnancies and the number of children born.

7. Data on abortions: date of holding, term of interrupted pregnancy, etc.

This information will allow the doctor to predict possible inflammatory processes of the uterus and appendages, which can provoke a miscarriage or premature birth, as well as cause abnormal labor and complications after childbirth.

8. Date and time of previous preterm birth. These data will help to identify the reasons why the pregnant woman developed a tendency to this pathological condition.

9. Date of the first day of the last menstrual period before pregnancy. This will help determine the approximate gestational age.

10. Gestational age during the first appointment at the antenatal clinic (LC). This information is necessary for the doctor to track the responsibility of the pregnant woman for her health and the health of the unborn child.

11. Number of visits female consultation. Usually the average number of visits is 10.

After the first admission to the LCD, the next visit should take place in 7-10 days in order to evaluate the results of the analyzes received and the conclusions of other specialists (otolaryngologist, dentist, ophthalmologist, endocrinologist, etc.)

Schedule of visiting the LCD:

  • up to 28 weeks - once a month;
  • up to 37 weeks - twice a month;
  • after 37 weeks - every 7-10 days.

If any pathology is found in a pregnant woman, then this becomes a reason for more frequent visits to the LCD. The schedule is negotiated individually.

12. Date of first fetal movement- information to determine the expected date of delivery.

It is important to know that during repeated pregnancies, the first movements and tremors of the fetus are felt earlier than during the first pregnancy.

13. Features of the course of pregnancy. Here I write down all deviations and complications.

14. Pelvis sizes. If at least one of the measurements of the pelvis is less than normal, then this is a reason to consider it narrow, which can lead to a difficult passage of the child through the birth canal.

15. Weight and height at the first visit to the LC.

If a pregnant woman has a height below 150 cm, this threatens to deform the spine and hip joints in late pregnancy, and also cause narrowing of the pelvic bones.

Weight gain for more than 40 weeks is 10-11 kg.

16. Fetal position- an important indicator for the management of childbirth. The final position of the fetus takes on a period of 37-40 weeks.

The position of the fetus can be longitudinal (normal), transverse or oblique (pathology).

17. presenting part b - this is the part of the fetus that first passes through the birth canal. The method of delivery depends on the nature of this parameter.

18. Fetal heartbeat. By the frequency and nature of the fetal heartbeat, you can determine its condition. And in the place of his listening - the location of the child in the womb.

For a baby in the womb, the normal heart rate is 140 beats per minute. This indicator is indicated in the exchange card after 32 weeks.

19. Laboratory tests. This item is the most important for the expectant mother: all tests for HIV infection and AIDS, syphilis, hepatitis B and C are noted here.

Without these tests, a pregnant woman is considered conditionally infected and cannot be admitted to a regular maternity ward, but is redirected to a special center for infected women in labor.

20. Rh factor. If a negative Rh factor is found in a pregnant woman, then her body will regard the child as a foreign body and reject it in every possible way. Therefore, a woman may have frequent miscarriages in the early stages. The antibody titer will allow you to choose the optimal nature of pregnancy and delivery.

21. Blood type. This indicator is important if a woman needs a blood transfusion.

If the mother and child have different blood types, then the fetus develops hemolytic disease. Also, if the mother has a negative Rh factor, then it is necessary to determine which Rh factor the father of the child has.

22. Clinical analysis of urine and blood. Standard procedures for diagnosing the general condition of a pregnant woman.

Analyzes are taken when a woman is registered with the LCD, at 18 weeks and at 30 weeks of pregnancy.

If there are complications, then additional tests are taken as prescribed by the doctor.

23. Analysis of blood clotting factors: platelet count, prothrombin index, bleeding time and blood clotting.

These indicators are necessary for accurate prediction of possible complications during labor bleeding.

Analyzes are taken three times: during registration, at 22 or 24 weeks and at 32 weeks of pregnancy.

Also, during the period of bearing a child, a biochemical blood test is taken twice.

Bad performance analyzes show complications during pregnancy, imbalance of essential substances in the mother's body. Clinical analysis of urine handed over at each visit to the gynecologist: 10 times (ideally) during the normal course of pregnancy. Only one indicator is recorded in the exchange card - protein in the urine ( lack of protein is considered normal).

24. Vaginal smear. As with a regular examination, this analysis is necessary for the timely detection of inflammation and infectious diseases.

Any infection can cause congenital pathologies, difficult childbirth and prolonged recovery of the mother in the postpartum period.

25. Fecal analysis- to detect helminthiasis and its timely treatment.

26. Date of vaccination with staphylococcal toxoid. It is done only if the pregnant woman has a long-term inflammatory process. An injection (dose of 0.5 ml) is given subcutaneously under the shoulder blade at 32 weeks, 34 weeks and 36 weeks of pregnancy.

27. Blood pressure (BP). An increase in blood pressure to 135/85 is the first indicator of preeclampsia, which is accompanied by edema and the presence of protein in the urine.

28. The number of classes attended by physiotherapy exercises (LFK).

Unfortunately, not all clinics and antenatal clinics provide special training for expectant mothers, so your doctor may recommend specific or general exercises for exercise during pregnancy.

29. Psychological preparation of the mother for childbirth. From the 28th to the 30th week of pregnancy, the obstetrician-gynecologist conducts 10 special classes in the LCD.

30. Number of classes attended by mothers at school. This is where childcare comes into play.

31. Date of issue of the certificate of incapacity for work on maternity leave. This maternity leave document is issued at the 30th week of pregnancy.

32. Estimated date of delivery (ED) determined based on various parameters.

33. Diary of visits filled in from 32 weeks of gestation.

34. weight gain chart for the entire pregnancy. This indicator helps to predict possible complications in the 3rd trimester and during childbirth.

35. Approximate fetal weight. An indicator that helps determine the tactics of childbirth. It is entered into the exchange card at 37 weeks, when the pregnancy is considered full-term.

36. Results of triple ultrasound: at 10-14, 20-24 and at 32-34 weeks.

37. Full name of the obstetrician-gynecologist who oversees the pregnancy, and his signature.

Part 2. Information of the maternity hospital about the puerperal

This coupon is filled in the maternity ward, where all the features of the course of the birth process and the early postpartum period are entered. The woman sends this information to the LCD.

This part of the exchange card contains the following information:

1. Full name of the puerperal, her age, address, date of admission to the maternity ward and date of delivery.

The date of birth is indicated for issuing a birth certificate for the child, and in the case of difficult births, for drawing up an additional disability certificate.

2. Features of the birth process: duration, abnormalities or complications in mother and child. Was the birth natural or a caesarean section was scheduled, and for what reasons.

3. Anesthesia method: indicate all data on methods for detecting possible neurological complications. For example: pain in the spine after spinal anesthesia.

4. Features of the course of the early postpartum period.

5. Date of discharge from the hospital. They also indicate what day it was after the birth of the child. This period is affected by the general condition of the mother and child.

6. Mother's health status at checkout.

7. Child's condition at birth, in the hospital and at the time of discharge.

8. Newborn weight in the first minutes of life and at discharge.

9. Baby growth at birth.

10. The need for a puerperal in patronage e. Sometimes, after discharge from the maternity ward, a woman needs an obstetrician-gynecologist at home.

11. Special remarks. This column indicates the number of additional days that are added to the issued sick leave for prenatal leave.

12. Full name of the obstetrician maternity hospital and his signature.

Part 3. Information from the maternity hospital about the newborn

In this ticket neonatologist indicates information about the newborn, who observes the child from the moment of his birth and captures all his features and indicators. The woman must provide information from this part of the exchange card pediatrician in a children's clinic.

The ticket consists of the following items:

1. Full name, address of the mother, date of delivery, what pregnancy was on the account, in what week of pregnancy the birth took place, information about unsuccessful previous pregnancies (artificial or spontaneous abortion, stillbirth).

2. childbirth: Single or multiple. In case of multiple births, they indicate how the baby was born in a row.

3. Duration of labor, the presence of complications in the mother and child.

4. Application of anesthesia(what method was used and what is its effectiveness).

6. Discharge day: indicate what was the day after the birth.

7. Mother's health status at checkout.

8. Gender and height of the newborn, his weight at birth and at the time of discharge.

9. Assessment of the newborn on the Apgar scale. The efficiency of all organs of the child is taken into account at 1 and 5 minutes of his life.

The maximum score is 10. It is determined by the pediatrician of the maternity hospital.

10. Did the newborn cry straightaway. This is the reaction of the child to the postponed birth and an indicator of his well-being.

11. Revitalizing a child: what measures have been taken, what is their effectiveness.

12. What day of life the baby was first attached to the breast in the maternity home.

13. Type of feeding: breast, expressed mother's or donor's milk, artificial mixtures.

To exchange card make only the mixture to which the child is not allergic. If the child is bottle-fed or accepts donor milk, then indicate the reasons for not breastfeeding.

14. On what day of life did the umbilical cord fall off.

15. Diseases of the child in the hospital: diagnosis, treatment, condition at discharge.

16. Tuberculosis vaccination(In case of refusal, the reason must be indicated).

18. Special remarks.

19. Date of completion.

20. Full name of the obstetrician-gynecologist and pediatrician of the maternity hospital and their signatures.

We wish you easy delivery and healthy babies!

First includes information from the antenatal clinic about the pregnant woman. Here, the doctor of the antenatal clinic, with whom the woman is registered, enters all the information about the features of the course of pregnancy, the condition of the woman, childbirth, and the postpartum period.

At each visit of the expectant mother to the consultation, new data are recorded in the card based on the examination and the studies carried out. When entering a hospital, a pregnant woman is required to present her “exchange”.

This section contains the following information:

  1. FULL NAME. pregnant.
  2. her age(early and late pregnancies can be accompanied by various problems in bearing a child).
  3. The address, which is necessary for emergency cases when it is difficult or impossible to contact the pregnant woman, and there is a need to find out the necessary information from relatives or cohabitants of the pregnant woman.
  4. General and gynecological operations that the woman has endured. Childhood, chronic and hereditary diseases are important because of their possible negative impact on the course of pregnancy, fetal development and childbirth.
  5. Features of previous pregnancies, childbirth and the postpartum period. If there were any complications before, then the woman is monitored more carefully for the timely detection of pathological conditions (early or late,). If performed in the past, surgery will most likely be recommended this time as well.
  6. Number of previous pregnancies, the number of children born will be needed to predict the course of the current birth.
  7. Number of abortions, if any (the year of the operation, the term of the interrupted pregnancy). This information is necessary so that the doctor knows about the possible development of consequences: inflammatory diseases of the uterus and its appendages. This can lead to miscarriage or premature birth, improper labor, complications during the postpartum recovery period.
  8. Year and term of preterm birth, which indicate the propensity of a pregnant woman to certain pathological conditions.
  9. Date of the first day of the last menstrual period, which will help determine the approximate gestational age.
  10. Pregnancy period at the first consultation visit. Such data is needed to calculate the date of the expected birth. Based on this information, the doctor often draws conclusions about the responsibility of the pregnant woman for her health and the health of the unborn child.
  11. Number of visits. In normal pregnancy - 10 times (after the first visit - the appearance should take place in 7-10 days to evaluate the results of tests, the conclusions of the therapist and other specialists: an otolaryngologist, dentist, ophthalmologist, endocrinologist, if necessary). Before - 1 time per month, before - twice a month, and after - every 7-10 days). Pregnancy, accompanied by any pathology, is a weighty argument for more frequent visits to the obstetrician-gynecologist. The frequency of visits is determined individually.
  12. Date to calculate the estimated due date. With repeated pregnancies, the first tremors are felt earlier than with the first bearing of a child.
  13. Features of the course of pregnancy. Any complications affect the course of childbirth and the postpartum period.
  14. Pelvis dimensions. The pelvis is considered if at least one of the measurements does not correspond to the norm. In this case, there is a risk of complicated passage of a child (especially a large one) through the birth canal.
  15. Weight and height at first visit. Growth below 150 cm is fraught with deformation of the spine and hip joints. As a result, the pelvis may narrow. Weight gain for an average of 10-11 kg.
  16. The position of the fetus is important for the management of labor. The final position of the fetus takes on a period of 37-40 weeks. The position can be longitudinal, transverse and oblique. The first is the norm, 2 and 3 are pathologies that will make it difficult for the child to pass normally through the birth canal.
  17. presenting part This part of the fetus is the first to pass through the birth canal. This may be the child's head (back of the head, face or crown) or the pelvis (legs or buttocks). The most favorable presentation is head. The definition of this parameter allows you to pre-select the method of delivery.
  18. . By its frequency and nature, the condition of the fetus can be assessed (the norm is a clear and rhythmic heartbeat up to 140 beats per minute). By listening to the heartbeat, you can find out the location of the child in the uterus. The exchange card indicates the fetal heartbeat, starting from the due date.
  19. Laboratory tests. This includes a three-time check for the presence of viral B and C (at registration, at and a few weeks before the DA).
  20. Rh factor. In a pregnant woman, the body perceives the fetus as a foreign object, which leads to its anemia. And this is fraught with a miscarriage, a stop in the development of pregnancy. The antibody titer allows you to choose the optimal tactics for managing pregnancy and the method of delivery.
  21. Blood type. If the blood groups of the mother and fetus are incompatible, hemolytic disease may develop in the child. Also, the definition of this parameter is necessary for emergency cases, when there is a need for an urgent blood transfusion. If a woman has a negative Rh, then it is necessary to establish the Rh-affiliation of the blood of the father of the unborn child.
  22. Clinical analyzes of urine and blood. A complete blood count is done 3-4 times during the entire pregnancy (if there are no complications): at registration, at 18 and at 30 weeks.
  23. Analysis of blood clotting factors: platelets, prothrombin index, bleeding time and blood coagulation. This study is necessary in order to clarify the possibility of complications in childbirth when it occurs. It is carried out three times - during registration, at 22-24 and at 32 weeks. Twice during pregnancy, a biochemical blood test is also given.

    Poor indicators may indicate a complication of the course of pregnancy, an imbalance of essential substances. A general urine test should be taken at each visit to the doctor - 10 times during the normal course of pregnancy. Only one indicator is entered in the exchange card - protein in the urine (its absence is the norm).

  24. Vaginal swab. This analysis allows you to find out about the presence of an inflammatory process and infections in a woman, which can lead to endometritis and sepsis in the mother, and in the child - to congenital malformations and pathologies, postpartum complications.
  25. Kal to exclude helminthic invasion in a pregnant woman (eggs).
  26. Date of administration of staphylococcal toxoid. If a pregnant woman has a chronic inflammatory disease, a microbiological study is performed to identify staphylococcus aureus, which is dangerous for the mother and child with complications during childbirth and the postpartum period. To prevent infection of a newborn at 32, 34, immunization with staphylococcal toxoid is carried out in 0.5 ml. The injection is made subcutaneously under the shoulder blade.
  27. Arterial pressure. An increase in this indicator to 135/85 may indicate development, especially if protein is also present in the urine.
  28. Number of physical therapy sessions(Today, clinics rarely conduct such training, so the doctor can only advise the permitted exercises during pregnancy, if, of course, the condition of the expectant mother allows them to be performed).
  29. Psychological preparation for childbirth. From 28-30 weeks, the obstetrician-gynecologist conducts 10 sessions in the antenatal clinic.
  30. mothers school. Classes cover issues of child care. The exchange card indicates the number of classes attended.
  31. Date of issue of the certificate of incapacity for work on prenatal leave (discharged at 30 weeks of pregnancy.
  32. Estimated date of birth determined based on various parameters.
  33. Diary of visits(to be completed from 32 weeks).
  34. weight gain chart for the entire pregnancy. This algorithm is important for predicting complications in the 3rd trimester and childbirth.
  35. Exemplary to determine the tactics of conducting childbirth. It is entered into the exchange card when the pregnancy is already considered full-term - at 37 weeks.
  36. Results of a 3-time ultrasound examination: at 10-14, 20-24 and at 32-.
  37. FULL NAME. obstetrician-gynecologist leading the pregnancy, and his signature.

Second part

In the second part contains information from the maternity hospital about the woman in labor. It is filled in the obstetric department before the woman is discharged for further transfer to the antenatal clinic.

This includes detailed data on the course of childbirth, the postpartum state. This will allow you to choose the right tactics for the rehabilitation of a woman after delivery.

  1. Full name, age, address, date of admission and date of delivery. The latter is needed when issuing a birth certificate for a child and in case of difficult childbirth - to draw up an additional certificate of incapacity for work.
  2. Features of the birth process(duration, any complications in the mother and fetus).
  3. It is indicated was there a caesarean section and for what reasons.
  4. Anesthesia method(whether it was used, which one and what was its effectiveness). This is important for the analysis of possible neurological complications (back pain) after spinal cord surgery.
  5. Features of the flow postpartum period.
  6. Date of discharge from the hospital(what is the day after the birth of the child). The condition of the mother and baby affects the determination of this period.
  7. Mother's health status at checkout.
  8. Baby's condition at birth, in the hospital and at discharge. Such data are needed to analyze the correctness of pregnancy management.
  9. Newborn weight in the first minutes of life and at discharge.
  10. Baby growth at birth.
  11. The need for maternal care. Sometimes, after discharge, a woman may need a home consultation with an obstetrician-gynecologist at home.
  12. Special remarks. This column usually indicates the number of additional days to the issued sick leave for prenatal leave.
  13. FULL NAME. and signature obstetrician at the maternity hospital.

The third part

The third part exchange card - this is information from the hospital about the newborn. Its filling is the responsibility of a specialist in the pediatric department of an obstetric hospital.

Information about the course of childbirth and the condition of the baby is entered before the discharge of the baby.

The mother or her relatives must transfer this coupon to the children's clinic, where the child will be observed in the future, within a few days after discharge.

  1. Full name, address of the mother, date of delivery, what pregnancy is on the account, in which week of pregnancy the birth took place, information about unsuccessful previous births (artificial, spontaneous abortion, stillbirth).
  2. Childbirth: single or multiple. It is recorded how the baby was born in a row if the birth was multiple.
  3. Duration of labor, the presence of complications in the mother and fetus).
  4. The use of anesthesia I (whether it was used, which one and its effectiveness).
  5. Peculiarities postpartum period.
  6. On what day after the birth took place extract?
  7. Health status mother at discharge.
  8. Gender and height newborn, its weight at birth and at discharge.
  9. Grade baby's condition at birth. The functioning of the organs and systems of the child is taken into account for 1 and 5 minutes. his life. The maximum score is 10. It is determined by the pediatrician of the maternity hospital, who was present at the birth.
  10. Did the newborn cry at once? This is an indicator of the well-being of the baby in the womb and his reaction to the transferred birth.
  11. Have you taken steps to revive and which ones exactly?
  12. What day of life baby for the first time attached to the breast in a maternity home?
  13. Type of feeding(breast, expressed milk of mother or donor). The mixture used is indicated to which the infant is not allergic. If the child is fed with donor breast milk, reasons must be given.
  14. What day of life the umbilical cord fell off?
  15. It is indicated did the child get sick in the maternity home.
  16. Diagnosis, treatment, condition at discharge.
  17. Tuberculosis vaccination(in case of refusal - the reason is indicated).
  18. Care instructions.
  19. Special remarks.
  20. Date of completion.
  21. FULL NAME. and signatures obstetrician-gynecologist and pediatrician of the maternity hospital.