Recording a new pregnancy

When a woman presents with a confirmed pregnancy, start a new pregnancy.

The Obstetrics tab is available only for patients with a sex of Female.
Tip:
Your site may have defined a custom clinical item for start of a pregnancy.

You can record a new pregnancy either on the Obstetrics tab, or by selecting one of the other pregnancy clinical items as normal. Use the Obstetrics tab to record the pregnancy details described here.

To start a new, confirmed pregancy:
  1. In the patient's clinical record, go to the Summary > Obstetrics > Obstetric History tab.
  2. Click New Pregnancy > Pregnancy;confirmed.
  3. In the Add Clinical Item window for Pregnancy;confirmed, complete the details.
    The only required field is Pregnancy Number which increments automatically for all ICPC-2 PLUS clinical items that record a pregnancy start in Communicare.
    Note:
    Ensure that you record the correct pregnancy number even if previous pregnancies are not yet recorded. Communicare uses the pregnancy number to link pregnancy checks and pregnancy end.
  4. Record the estimated delivery date (EDD) using one of the following methods:
    • LNMP:
      1. If known, from the Date of LNMP calendar, select the date that the patient's last normal menstrual period (LNMP) commenced.
      2. Click in the Estimated delivery (by date) field and in the Confirm window, click Yes.
    • Ultrasound: if an ultrasound has already been performed and an estimated delivery date acquired, enter the this date in the Estimated delivery (by ultrasound) field.
    Tip:

    If you click in the Estimated delivery (by date) field after you enter an Estimated delivery (by ultrasound) and confirm it, the Estimated delivery (by ultrasound) date is used.

    If required, you can override the calculated date: click in the Estimated delivery (by date) and enter the required date.

  5. To calculate the gestation, click in the Gestation field.
    Gestation is calculated by counting back from the EDD to the date of the clinical item.
  6. If you want to record previous pregnancies in Communicare without having to record the entire history as individual past pregnancies, in the Gravida field, enter the total number of pregnancies including the current pregnancy.
    • If you want to distinguish between pregnancies, click in the Parity, Number of miscarriages or Number of terminations and enter the number of pregnancies with each outcome.
    • To view details of previous pregnancies, click Chart buttonChart.
  7. Enter any foetal observations and other information.
  8. Click Save.
  9. If there are existing medications that interact with a pregnancy, the Pregnancy Interactions window is displayed. Read the interactions and click Noted.
  10. In the Confirm Automatic Recall window, set a recall interval and responsibility and click Save.
The patient's current pregnancy information is displayed on the Summary > Obstetrics > Current Pregnancy tab and a pregnancy alert is displayed in the banner.
Patient banner with pregnancy indication
Remember:
If there were any pregnancy interaction warnings, go to the Medication Summary and review the patient's current medications.

Record any updates to the estimated delivery, antenatal checkups and other obstetric immunisations and procedures in new clinical items.

To edit the original Pregnancy;confirmed item, on the Current Pregnancy tab, click Current Pregnancy No..

Note:
Do not edit the original Pregnancy;confirmed item to edit the EDD. Instead add a new antenatal checkup.