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Females < 18 yrs with Behavioral Health Concerns and Pregnancy — History and Physical Exam — Clinical Pathway: Emergency Department

Behavioral Health Concerns and Pregnancy, Females < 18 yrs — Clinical Pathway

History and Physical Exam

Background

  • Adolescent pregnancy is associated higher rated of depression rates and PTSD is common
  • Clinicians may fail to identify moderate and even severe symptoms
  • AAP and ACOG recommend screening for depression and anxiety at least once in the perinatal period
  • Psychoeducational therapy and supportive interventions can improve neonatal/post-natal outcomes
History of Present Illness
Past Medical History
  • Existing diagnoses
  • Medical hospitalizations, surgeries
  • Psychiatric hospitalizations
  • Current behavioral health treatment
  • Medications, including psychiatric medications
Social History
Physical Exam
  • Full VS, weight
  • < 12 wks: Pelvic organ, unable to palpate
  • 12 wks: Palpable just above the pubic symphysis
  • 16 wks: Palpable midway between pubic symphysis and umbilicus
  • 20 wks: Palpable at umbilicus

 

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