creation date: 2026-10-09 20:58
tags: Assessments
Obstetrics Triage
Background
Obstetrics triage assessment is a service available for pregnant individuals to seek assessment regarding concerns.
Common presentations include:
- Contractions
- Vaginal bleeding
- Decreased fetal movement
- Discharge/loss of fluid
- Abdominal pain
But triage is available for any concerns.
History
Current pregnancy and obstetrics history
Many aspects of the history is available in the chart or the antenatal form.
- GTPAL
- Complications in existing pregnancy (incl. AMA which is age >40)
- Current medications and conditions
- Blood and screen
- Serologies and GBS status
- OGTT status
Cardinal obstetric triage symptoms
Vaginal bleeding
- Amount of blood
- Small amount + mucousy discharge - “blood show” at onset of labour
Loss of fluid
- Colour of fluid (any green/yellow)
- Was there a gush
Change in fetal movement
- Less movement at any point
Uterine contraction
- Regularity
- Frequency of contractions
- Duration of contractions
Additional focused history
Additional symptoms may be questioned, in particular, preeclampsia related:
- Headache
- Vision changes
- RUQ pain
- Urine output decrease
- Dyspnea/SOB
- Leg swelling
For vaginal bleeding:
- Painful (abruption pathway) vs. painless (previa, vaso previa)
- Trauma/injury
- Evidence of placental previa/low-lying placenta
Investigations
Decreased fetal movement
Provide a clicker and have mom click when movement is felt. Reassuring if >6 clicks in 2 hours.
Rupture of membrane
ROM is confirmed by microscopy of the fluid. Evidence of ROM is if fern-like crystals are visualized.
Hypertension/Preeclampsia
Blood pressure is checked several times for elevation. If preeclampsia is suspected:
- CBC with platelets
- Serum creatinine
- Liver function tests
- Urinalysis for proteinuria
Note that if presenting with isolated high BP readings, several normal repeat readings is sufficient and further work up unnecessary.
Trauma
Kleihauser-Betke test is ordered to determine extent of fetalmaternal bleeding. It can be used to titrate RhoGAM dosing as well.