This second edition of the Handbook of Obstetrics and Gynaecology has become necessary because of the increasing growth in know­ ledge and changing ideas on Obstetrics and Gynaecology. Never­ theless, we have attempted to maintain the same basic approach and concepts to student learning as we evinced in the first edition. Any changes to the text are updating of existing practices and knowledge or correction of errors in the original text. The Handbook is still a guide to achieving mastery of the undergraduate curriculum, but over the past five years we have realised the book is also widely used by general practitioners and nurses as well as undergraduate students. It is tempting to enlarge the handbook to encompass all the needs of diverse groups of health personnel, but we have resisted this desire. Instead, the Handbook of Obstetrics and Gynaecology can be regarded as a true guide to aid students in the application of knowledge to the clinical setting. In conjunction with one of the major recom­ mended text books, this book provides a useful aid to students and general practitioners. I hope all who read it continue to find it useful. BARRY G. WREN 1984 Chapter 1 History Taking and Physical Examination BARRY G. WREN GENERAL INSTRUCTIONAL OBJECTIVE The students will develop competence in taking a history and perform­ ing a physical examination so that obstetric or gynaecological abnormali­ ties can be recognized and appropriate management initiated.