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The Gyneco-Obstetric History (Antecedentes Gineco-Obstétricos) module provides comprehensive documentation of reproductive health for female patients. It includes automatic calculations, validation, and specialized fields for pregnancy, menstrual history, and preventive screenings.

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Overview

This module is exclusively for female patients and includes:
  • Current pregnancy status tracking
  • Obstetric history (GPAC notation)
  • Menstrual and reproductive history
  • Preventive health screenings (Pap smear, mammography)
  • Automatic gestational age calculations
This module is only accessible for patients with sex registered as “Femenino”. Male or non-specified patients will see a modal explaining that this section does not apply.

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Current pregnancy section

A simple checkbox indicates if the patient is currently pregnant: 
☑ Paciente actualmente embarazada
When checked:
  • The FPP (Fecha Probable de Parto) field becomes active and auto-calculated
  • The FUM field is highlighted as required
  • Additional pregnancy-related validations activate

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Obstetric history (GPAC)

The module uses standard GPAC notation:
  • G = Gestas (Total pregnancies)
  • P = Paras (Live births)
  • A = Abortos (Abortions/miscarriages)
  • C = Cesáreas (Cesarean sections)

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Automatic calculation

Gestas are automatically calculated as: Paras + Abortos + Cesáreas
You only need to enter:
  • Paras: Number of deliveries (vaginal or cesarean) resulting in live birth
  • Abortos: Pregnancies ending before 20 weeks
  • Cesáreas: Number of cesarean deliveries
The system automatically:
  1. Sums the three values
  2. Updates the Gestas field
  3. Displays the complete GPAC notation as a badge (e.g., “G3P2A0C1”)

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Field definitions with tooltips

Each GPAC field includes an info icon (ⓘ) with detailed explanation: Gestas:
  • Calculated automatically
  • Represents total number of pregnancies
  • Read-only field with gray background
Paras:
  • Deliveries after 20 weeks gestation
  • Includes term (≥37 weeks) and preterm (20-37 weeks)
  • Must result in live birth
Abortos:
  • Pregnancies ending before 20 weeks
  • Includes spontaneous and induced
  • Total count regardless of cause
Cesáreas:
  • Deliveries performed surgically
  • Count of cesarean sections
  • Included in Paras count

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Menstrual history

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FUM (Fecha Última Menstruación)

Date field: First day of last menstrual period
When the patient is pregnant and FUM is entered, the FPP (due date) is automatically calculated using Naegele’s Rule.
If pregnant and FUM not entered:
  • Field highlights with primary color border
  • Pulsing animation draws attention
  • Red asterisk (*) indicates required
  • Placeholder message: “Capture primero la FUM para calcular la FPP”

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FPP (Fecha Probable de Parto)

Auto-calculated field using Naegele’s Rule: 
FPP = FUM + 7 days - 3 months + 1 year
Or equivalently: FUM + 280 days (40 weeks) Conditions for calculation:
  • Patient must be marked as currently pregnant
  • FUM must be entered
  • Calculation updates in real-time
Field behavior:
  • Read-only (cannot be manually edited)
  • Gray background indicates auto-calculated
  • Format: YYYY-MM-DD
  • Clears automatically if pregnancy checkbox unchecked

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Other menstrual fields

Menarquía (Age at first menstruation):
  • Numeric field (years)
  • Typical range: 9-16 years
IVSA (Inicio de Vida Sexual Activa):
  • Age when sexual activity began
  • Numeric field with 0-100 validation
Ritmo Menstrual:
  • Describes cycle pattern
  • Format: “28x5” (28-day cycle, 5 days bleeding)
  • Free text field
Método Anticonceptivo:
  • Current contraceptive method
  • Examples: “DIU”, “Píldoras”, “Ninguno”
  • Free text field
Fecha Menopausia:
  • Date of menopause onset
  • Date picker field
  • Leave blank if not applicable

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Preventive health screenings

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Papanicolaou (Pap smear)

Fecha Último Papanicolau:
  • Date of last cervical cytology
  • Used to track screening compliance
Resultado Último Papanicolau:
  • Result classification
  • Common values:
    • “Normal”
    • “ASCUS” (Atypical Squamous Cells of Undetermined Significance)
    • “NIC I/II/III” (Cervical Intraepithelial Neoplasia grades)
    • “Carcinoma”

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Mammography

Fecha Última Mamografía:
  • Date of last mammogram
  • Important for breast cancer screening
Resultado Última Mamografía:
  • Result using BIRADS classification
  • Common values:
    • “BIRADS 1” (Normal)
    • “BIRADS 2” (Benign findings)
    • “BIRADS 3” (Probably benign)
    • “BIRADS 4” (Suspicious)
    • “BIRADS 5” (Highly suspicious)
    • “BIRADS 6” (Known cancer)

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Additional notes

Free-text area for:
  • Sexually transmitted infections
  • Gynecological surgeries (hysterectomy, oophorectomy)
  • Fertility issues or treatments
  • Menopause symptoms
  • Any other relevant reproductive health information

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Real-time summary

A dynamic summary section displays colored badges: Pregnancy status (yellow badge):
  • “Embarazada actualmente” if checked
GPAC values (color-coded):
  • Gestas (primary color)
  • Paras (green)
  • Abortos (red)
  • Cesáreas (yellow)
Key dates:
  • FUM (primary color)
  • FPP (yellow, if pregnant)
  • Menarquia age (primary color)
  • IVSA age (primary color)
Screenings:
  • Papanicolaou date and result (blue)
  • Mamografía date and result (green)
The summary updates instantly as you enter data, providing at-a-glance verification of entered information.

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Data validation

The form uses Zod schema validation: 
const gynecoObstetricSchema = z.object({
  embarazo_actual: z.boolean().nullable().optional(),
  gestas: z.number().int().min(0).nullable().optional(),
  paras: z.number().int().min(0).nullable().optional(),
  abortos: z.number().int().min(0).nullable().optional(),
  cesareas: z.number().int().min(0).nullable().optional(),
  fum: z.string().nullable().optional(),
  menarquia: z.number().int().min(0).nullable().optional(),
  ivsa: z.number().int().min(0).max(100).nullable().optional(),
  // ... other fields
});
Key validations:
  • GPAC values must be non-negative integers
  • IVSA limited to 0-100 years
  • Empty strings converted to null for date fields
  • All fields optional (can be null)

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Saving and updating

Click Guardar to save changes. Save logic:
  • New record: Creates if no gyneco-obstetric history exists for patient
  • Update: Modifies existing record based on patient_id
  • Auto-fields: user_id, idbu, and updated_at automatically injected
1

Enter data

Fill in relevant fields across all sections.
2

Verify calculations

Check that Gestas and FPP (if applicable) are correctly calculated.
3

Save

Click the Guardar button at the bottom of the form.
4

Confirm

Form reloads with saved data. No explicit success message, but data persists.
Click “Imprimir Informe” to generate a formatted gyneco-obstetric report including:
  • Patient identification
  • Current pregnancy status and FPP
  • Complete GPAC notation
  • Menstrual history details
  • Screening dates and results
  • Additional notes

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Clinical guidelines

Pap smear:
  • Start: Age 21
  • Frequency: Every 3 years (ages 21-29)
  • Every 5 years with HPV co-testing (ages 30-65)
  • Stop: Age 65 (if adequate prior screening)
Mammography:
  • Start: Age 40-50 (based on risk factors)
  • Frequency: Annually or biennially
  • Continue based on life expectancy

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High-risk indicators

Consider high-risk management for:
  • History of multiple miscarriages (≥3)
  • Previous preterm deliveries
  • Multiple cesarean sections
  • Abnormal Pap or mammography results
  • Family history of reproductive cancers

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Pregnancy calculations

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Gestational age from FUM

Based on FUM, calculate:
  • Weeks pregnant: (Today - FUM) / 7
  • Trimester:
    • 1st: 0-13 weeks
    • 2nd: 14-27 weeks
    • 3rd: 28-40 weeks

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Expected delivery date

Naegele’s Rule provides FPP:
  • Assumes 28-day cycle
  • May need adjustment for irregular cycles
  • Ultrasound dating more accurate (especially in first trimester)

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Source code reference

Implemented in:
  • /workspace/source/src/pages/GynecoObstetricHistory.tsx (1042 lines)
  • /workspace/source/src/services/gynecoObstetricService.ts - Service layer
Key features:
  • Auto-calculation with useEffect hooks
  • Real-time FPP calculation from FUM
  • Auto-sum of Gestas from P+A+C
  • Conditional rendering based on pregnancy status
  • Sex-based access control (female only)
API endpoints:
  • api.gynecoObstetricHistory.getByPatientId(patientId)
  • api.gynecoObstetricHistory.create(payload)
  • api.gynecoObstetricHistory.update(patientId, payload)
Date handling:
  • Uses date-fns for parsing and formatting
  • Stores dates as ISO strings in database
  • Displays in DD/MM/YYYY format in UI
  • Form uses YYYY-MM-DD for date inputs

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