Family history - irrelevant in modern obstetrics?

Trauma Columnist · Oct 16, 2004

Good question. I had my two sons in 1980 and 1985 and no one asked about anything except my own history.

dansamy · Oct 16, 2004

I was asked my mother's obstetric history. Turned out to be quite relevant. Pre-e *may* run in families. My mother had a moderate case with me. I had SEVERE pre-e/HELLP with all 3 of my pregnancies.

SmilingBluEyes · Oct 17, 2004

NO NOT IRRELEVANT> we DO take family histories and take them into consideration in treating OUR OB patients. And so do our doctors!

kids · Oct 17, 2004

During my daughter's pregnancy she started her care at a OB clinic for low to no income women. I have a pretty serious OB/Gyn history including probable DES exposure. My daughter was told that none of it mattered.

Mid-point in the pregnancy she changed providers to a private ON/Gyn practice.

Her new doc felt my history was significant to her prenatal care...based on my history a couple of tests were done, problems were detected and intervention probably prevented them from becoming serious.

reprise · Oct 17, 2004

I have a pretty serious OB/Gyn history including probable DES exposure. My daughter was told that none of it mattered.

Now that's scary.

I'm somewhat tempted to ask what drug is used for third stage management at the hospital where my daughter will be delivering. When I had my son, the hospital routinely administered ergometrine - to which I had a dangerous reaction. I'm pretty sure most hospitals here use syntocinon now, but I should probably check.

shay · Oct 17, 2004

OMG!!! Kids-r-fun, that's awful!! A DES daughter is nothing to take lightly. That's horrid. Family history is relevant. However, I don't know about you, but I'm a firm believer that how mom/sister labored means jack about how pt. will labor.

If it were always true that you labored like your mother, I would have had a short labor and pushed out a 7lb. baby like it was nothing. Instead I had an almost 9lb. baby via c-section. Where the heck was that good ol' genetic karma, man? :rotfl:

fergus51 · Oct 17, 2004

I don't think it's completely irrelevant, but it seldom changes our management of the patient either. We always err on the side of caution.

reprise · Oct 17, 2004

I don't think it's completely irrelevant, but it seldom changes our management of the patient either. We always err on the side of caution.

The only thing which really concerns me is the possibility of a drug reaction if ergometrine is used for third stage management. Reactions to other drugs are fairly consistent among the females in my family.

In all likelihood (grandbaby is being delivered in a hospital based birth centre), there'll be no need for active third stage management, but in the event that there is such a need it would be nice to avoid the potential problem of her diastolic BP going through the roof as mine did (it was not mismanagement in my case - ergometrine was routinely used at that time and there was no particular reason to believe that I was at increased risk from it; to this day, my medical files are flagged to ensure that I'm never given it again ).

I think that I'll probably mention it at the next antenatal appointment. That's the one where my daughter will be drawing up her birth plan and so third stage management will be under discussion anyway. For a while, most hospitals were using syntocinon routinely and only administering ergometrine for PPH, but from what I've read ergometrine is coming back into favour so it at least makes sense to find out about the standing orders at this particular facility.

Mermaid4 · Oct 25, 2004

WHAT?????? I always ask because I have found, even though most of our docs disagree, that a woman often has a similar labor history as her mother, and more than once, because I bothered to ask, I have discovered that a patient was adopted....