Antenatal Consultation Note

Date: [Date of the visit](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write on the same line as the label.) Patient Name: [Full name of the patient](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write on the same line as the label.) SUBJECTIVE [Introductory summary including pregnancy number, patient name, gestational age, and type of consultation](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write in paragraph format in full sentences.) - Gestation: [Current gestational age](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Expected Date of Delivery (EDD): [EDD date and method of calculation](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Presenting Complaint: [Patient's current symptoms, concerns, or complaints related to the pregnancy](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Obstetric History: [Gravida and para status, details of previous pregnancies including outcomes and complications](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Gynaecological History: [Menstrual history, contraceptive use, and gynaecological conditions](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Past Medical History: [Relevant medical conditions](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Past Surgical History: [Previous surgeries or procedures](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Medications: [Current medications including dosages](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Allergies: [Known allergies or drug reactions](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Family History: [Relevant family medical history](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Social History: [Relevant social factors including marital status, occupation, smoking, alcohol use, and substance use](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) OBJECTIVE - Weight at start of pregnancy: [Initial pregnancy weight](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Current weight: [Current weight](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) - Abdominal Examination: [Findings from abdominal examination](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) [Additional examination findings including any other relevant clinical observations](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) ULTRASOUND [Summary of ultrasound findings including fetal biometry, amniotic fluid volume, placental location, and any noted abnormalities](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write in paragraphs of full sentences.) ASSESSMENT [Numbered list of clinical assessments and diagnoses](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Do not invent or infer a diagnosis. Format as a numbered list.) PLAN [Numbered list of management plans, recommendations, and follow-up instructions](Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Format as a numbered list with detailed sub-points using bullet points where applicable.)