Get the free Pregnancy Outcome Summary Form - ncdhhs

1. Last name First name MI N.C. Department of Health and Human Services Division of Public Health Women's and Children's Health Section 2. Patient Number -3. Date of Birth Month 4. Race (Check all

How to fill out pregnancy outcome summary form

How to fill out pregnancy outcome summary form:

1. Begin by gathering all necessary information such as the date of the pregnancy outcome, the patient's name and medical record number, and the healthcare provider's contact information.
2. Document the type of pregnancy outcome, whether it was a live birth, stillbirth, or termination, and specify any complications or interventions that occurred during the pregnancy.
3. Record information about the newborn, including their weight, length, and any abnormalities or conditions present at birth.
4. Include details about the mother's health during pregnancy, such as gestational age, prenatal care received, and any medical conditions or medications that may have had an impact on the pregnancy outcome.
5. Provide information about the method of delivery, whether it was vaginal or caesarean, and any anesthesia administered during the process.
6. Document any additional procedures or treatments performed during the pregnancy outcome, such as resuscitation efforts for the newborn or postpartum care for the mother.

Who needs pregnancy outcome summary form:

1. Obstetricians and gynecologists who have provided prenatal care to the patient require the pregnancy outcome summary form to record and update the patient's medical history.
2. Hospitals and healthcare institutions utilize the form for documentation purposes and to maintain accurate records of pregnancy outcomes within their facility.
3. Researchers and statisticians may need the pregnancy outcome summary form to collect data and analyze trends in pregnancy outcomes within specific populations or regions.

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What is pregnancy outcome summary form?

The pregnancy outcome summary form is a document used to record and report the details of pregnancies, including information about the outcome and any complications that may have occurred.

Who is required to file pregnancy outcome summary form?

Medical professionals, such as doctors, midwives, and hospitals, are typically required to file the pregnancy outcome summary form. This helps to ensure accurate and comprehensive data collection for health monitoring and research purposes.

How to fill out pregnancy outcome summary form?

To fill out the pregnancy outcome summary form, the medical professional will need to provide details such as the patient's demographics, medical history, prenatal care received, details of the pregnancy outcome, and any complications or interventions that occurred during the pregnancy or delivery. The form will include specific sections and fields for each required piece of information.

What is the purpose of pregnancy outcome summary form?

The purpose of the pregnancy outcome summary form is to gather important data and statistics on pregnancies, including the outcomes and any complications that may have occurred. This information is used for research, monitoring public health trends, and improving maternal and infant healthcare services and policies.

What information must be reported on pregnancy outcome summary form?

The pregnancy outcome summary form typically requires the reporting of information such as the patient's demographics, medical history, prenatal care received, details of the pregnancy outcome (such as live birth, stillbirth, or miscarriage), and any complications or interventions that occurred during the pregnancy or delivery.