Basic Obstetrics and Gynaecology Examination

Dr Praneil PatelO&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?