Basic Obstetrics and Gynaecology Examination

Basic Obstetrics and Gynaecology Examination Dr Praneil Patel O&G

Preparation • History • Obstetrics • Gynaecology

Preparation • Clean your hands • Consent • Explain your actions • Privacy • Chaperone • Equipment

History • Full medical History • Obstetric History • Family History • Pregnancy Risk Factors

Definitions Gravidity – defined as the number of times a woman Parity – Defined as the number of times a woman has given birth to a fetus >24/40

Gynaecology • Abdominal Examination • Patient positioning • Examine external genitalia • Speculum

Trouble? • Try re-inserting the speculum • Valsalva • Reposition • Alternate speculum • Gloves • VE

Bimanual Examination • Patient positioning • Use both hands! • Place non-dominant hand on abdomen • Insert 1-2 fingers into the vagina, posterior to the cervix - size - cervical excitation - position - adnexal masses/excitation - mobility

Obstetrics • Examine the abdomen • Measure symphysis fundal height • Assess presentation & engagement • Auscultate FH

Don’t Forget • Assess BP • Urine dip • Oedema • Reflexes & clonus

Obstetric examination • Common place in DAU, Triage, labour ward. • Consider sterility & need for swabs • Why are you doing the speculum? • Fibronectin Test

Digital PV examination • Consider whether it is necessary? • What information do you want to know? • Dilatation - Membranes/Liquor • Consistency - Fetal position • Length - Caput • Position - Moulding • Station

Tips • Practise practise practise • Coordinators • Inductions • Sweeps • ARMs

Thank You • Any questions? • Or any other hints people can think of?

Basic Obstetrics and Gynaecology Examination