CARNETUL MEDICAL AL GRAVIDEI

18.1

Servete maternitii pentru cunoaterea strii de sntate a gravidei, prezentat pentru

natere.
Se completeaz ntr-un exemplar de medicul de familie sau cel din ambulatoriu care are n
eviden gravida, nmnndu-l acesteia la luarea n eviden.
Carnetul va nsoi gravida la fiecare consultaie prenatal urmnd a fi predat unitii sanitare
unde are loc naterea, odat cu internarea gravidei.

CARNETUL MEDICAL AL GRAVIDEI

Pstrai cu grij acest carnet fiind n interesul sntii dumneavoastr

i al copilului care se va nate

18.1; A5; t2

Judeul
Localitatea

Unitatea sanitar

CARNETUL MEDICAL AL GRAVIDEI

Numele ......................................................................................................................
Prenumele ........................................................................................... vrsta

ani

CNP

Grupa sanguin

Rh
RBW, gonococ i
chlamydia, HIV

Luat n eviden:

zz ll .................aa ........
Data ultimei menstruaii:

zz ll .................aa ........
DATA PROBABIL A NATERII

zz ll .................aa ........

STRI PATOLOGICE N TIMPUL SARCINII

Data (luna)

Afeciunea

SPITALIZRI N TIMPUL SARCINII pentru:

ANTECEDENTE PERSONALE

Fiziologice:

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ANTECEDENTE OBSTETRICALE

Nr. avorturi spontane:

Nr. nateri: ......................

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Intervenii chirurgicale mari: ...............................................................

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Patologice:...................................................................

Alte nsemnri: ................................................................................................

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Examene

Luna sarcinii

Greutatea
Tensiunea arterial
Ex. urin
Vitaminizri
Vaccinri antitetanice (ATPA)/
antidiftero-tetanice (dT)
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Explorri funcionale: .....................................................................................................................................................................................

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Examene de specialitate: ..............................................................................................................................................................................

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Examene radiologice: .....................................................................................................................................................................................

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Examen anatomopatologic: .......................................................................................................................................................................

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Recomandri la externare:

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continuare:

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continuare:

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Controale sau reinternri:

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continuare:

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