 Now, the history-taking, it must be emphasized that the gynecological examination always demands the presence of a well-trained chaperone because of litigation. Any good history taken from the patient must include the demographic information, the name, age and party of the patient, the age of the last child, and then the last normal menstrual period. The marital status and occupation may also be added. Now, the presenting complaints from the patient must be taken and the history of the presenting complaints must be well elucidated in chronological order. This must be done together with well-targeted specific questions to reinforce or clarify the history of presenting complaints. Also, it will be important to find out if there has been any previous treatment of the current condition. Then direct questioning is used to clarify some of the problems found. And then the various organ systems are also then reviewed for any problems that have not been mentioned by the patient. And that is the systematic inquiry. Now, one proceeds then to take the medical and surgical history. So, once you find out about the medical problems that the patient has, any significant problems such as hypertension, sickle cell disease, diabetes, mellitus, asthma, tuberculosis, GCCD defect, psychiatric illness, cardiac disease. And any other major illness that may be of interest. Now, if there has been any previous surgeries, find out about laparotomies and then their indications. The past obstetric history is also very important in the gynecological history taken. Now, one has to find out about the gravity and parity of the patient as mentioned in the demographic area. Now, the gravity refers to the number of times the client has been pregnant. The parity then refers to the number of times the client has delivered after the period of viability. The period of viability in Ghana is taken as 28 weeks. And with the parity, once the woman delivers, the baby need not be alive before you term it parity. It can be a still birth or it can be a live birth. Now, any deliveries before this period or any expulsion of the features before this period is usually termed a miscarriage or an abortion. Now, in certain areas, the period of viability may be defined as the gestational age of 22 to 24 weeks. And the WHO supports 22 weeks. Other areas in the world may use 24 weeks, 22, 23, 24 weeks as necessary. And this is according to the sophistication of neonatal care. Now, the previous abortions and atopic pregnancies will have to be noted. And multiple pregnancies should also be noted. But the delivery of a set of twins is taken as a single delivery. In other words, it confers only one parity status. And then the duration of labor of the previous deliveries is important. The mode of delivery is equally important, whether it's normal delivery or caesarean section or by instrumental delivery, all these are important. Now, the birth weight, the sex and the gestational ages that the children were born is very important. Now, if there were complications of the pregnancy, the labor and the puerperum, these also should be highlighted because they may have important bearings on the gynecological status of the woman. A typical example is postpartum cervical prolapse or uterine prolapse for which adequate treatment is needed. Later in life, the woman may actually develop full-blown pelvic organ prolapse. Now, the gynecological history itself, that involves the menstrual history, the contraceptive history, sexual or marital history, and the history of previous investigations or treatment, including surgery. Now, the menstrual history is important to find out about the last menstrual period again as highlighted in the demographic area. The age at Menaki, that means the first menstruation, and in writing up we represent this by a K, a capital K, the duration of the menstrual cycle and that is C, that means the cycle length. And the number of days of menstrual flow are all crucial. In a patient with a Menaki at 12 years with 5 days of menstrual flow in a regular 28 day cycle is written in short and form as capital K12 and then C5 over 28, that is the short and form. Now, one also has to find out if the menstruation has been regular. In a painful, that's dysmenorrhea or associated with heavy blood loss. An estimation of the blood loss may be helpful. Then one also has to determine the color of the menstrual and then the amount of flow. Is there any intermenstrual bleeding? Are there any other symptoms such as sweating, cramping, headaches or dizziness? The previous menstrual period may also be very helpful. The normal menstruation lasts between 2 and 8 days. Anything shorter or longer than this is abnormal and needs to be investigated. The patient also needs to be evaluated for the presence of motorcycle pain and disease. Now, motorcycle pain may be particularly important in patients seeking infertility treatment. That may be the time of ovulation and so most patients with infertility and severe motorcycle pain may not be having any sexual intercourse at this point in time. Therefore, miss the pregnancy altogether. But when they are put together during this period, pregnancy is easily achieved. Now, the history of previous investigations and treatment. It's important to find out about any previous vagina discharge, the pelvic infusions and then if there has been any previous gynecological surgery. For instance, minor surgery such as diagnostic DNC and other types of surgery including laparoscopy or raptured ectopic pregnancy are important. Major surgeries may include rheumatomy or hystratomy, the pelvic floor repair and operations for stress incontinence. The metroplasty, cervical comb biopsies are also important in their various forms either cold knife biopsy or large loop excision of the transformation zone and then repair of psychovagina fistula and rectovagina fistula. Now, one also has to find out if there has been any period of infertility and the treatment that has been given for it. Is there a history of previous pap smear? If so, what was the result and how long ago was it done? One also has to find out about any previous operations on the genital tract such as sorry, this is what I have talked about already. The contraceptive history is also important and one has to find out about the type of contraceptives used and the complications suffered so far. For instance, the presence of amenorrhea or thromboemboli phenomena or dysmenorrhea or menorrhagia and IUCD complications such as pain and vaginal discharge. The marital history or sexual history is also important. One has to find out if the couples are well and if the patient is married and the duration of their marriage. Is there a history of infertility and how long did it last? Is there any painful coitus, that means dysparunia? Is there sexual satisfaction? All these are important for the gynecological history. The social history comes next and one has to find out about the occupation of the woman and her husband and then we also have to find out about their habits especially of alcohol intake and cigarette smoking or tobacco smoking. The drug history is also equally important. One has to find out about the long term use of drugs. For instance, anti-abotensives or hypoglycemic agents. Is there any allergy to any food or to any drugs? Now, the gynecological history is basically the main elements of the history taken at the gynecological clinic is what I have discussed now. Now, the next stage will be for the physical examination of the patient and this will be demonstrated adequately on the video at the next section.