For patients presenting with CPP the gynaecological history needs be sufficiently broad as to enable understanding of the impact of symptoms. It is also useful to ascertain at an early stage whether the patient is primarily in search of symptom control, or of diagnosis, advice and explanation. Sometimes those with long standing and disabling symptoms are found to be reluctant to consider symptomatic treatments out of fear that some damaging disease process will be masked and overlooked. Table 43.1 presents a classification of causes of CPP that can be borne in mind while undertaking the clinical assessment.
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.