SEEN AT OBYS WARD R3
Gifty Aseidu 
21YRS OLD
G1P0
EDD 19/01/26
GA 31weeks +1day 
GROUP A
RH POSITIVE
HBS AG NEG
SICKLING ;NEG
G6PD : NO DEFECT
VDRL : NEG
HIV : 280
<24 hrs  ON ADMISSION
BEING MANAGED AS A CASE OF PROM @ 31weeks +1day 
CURRENTLY ON
TAB ERTHROMYCIN 500MG  QID FOR 7 DAYS 
TAB FERROUS SULPHATE 200MG 12 HRLY (30 DAYS )
TAB FOLIC ACID 5 MG daily (30 DAYS )
IV Ampicillin 1g QID for 48 hrs 
IV Dexamethasone 12mg 12hrlt for 24 hrs 
C/O : NIL
ODQS:
PFM+, LOL-, BPV-, WAIST PAIN -, ASYMPTOMATIC OF ANAEMIA -,FLASH OF LIGHT-, BNAUSEA-,VOMITING

O/E
adult female , well looking , not in any obvious pain /distress, anicteric , afebrile , p-, hydration satisfactory ,abdomen mwr, not tender , gravid  uterus SFH ;31cm  Cephalic presentation and longitudinal lie , no organomegaly .
 
Cardiopulmonary stable
BP: 100/60MMHG
P:90BPM
SP02: 98% ORA
Resp: RR - 18cpm, SpO2 - 98 % ORA. Chest is clinically clear.
CNS: GCS - 15/15. Grossly intact.

Plan +Dr Twumasi 
To do Fbc, urine r/e , crp , urine c/ s , HUS , endocervical swab 
To start tab erythromycin 500mg qid (7days) 
Tab Ampicillin 1 g 6 hrly *( 48hrs ) 
Monitor vitals 4hrly
Monitor vulva pads for liquor
Liberal hydration and feeding
To do formal obstetrics scan 
Daily fetal monitoring 
4 hrly maternal and fetal heart monitoring 
To give magnesium sulphate protection when she goes into labour
Bed rest