Obstetric Exam

Introduces self	0	1
Confirms name & age of patient	0	1
Explains & gains consent	0	1
Asks patient if they are feeling well and if they’ve observed any foetal movements today	0	1
Informs patient that a chaperone will be present	0	1
Asks patient to lie flat with some left tilt if required	0	1
Washes hands	0	1
Exposes patient’s abdomen from xiphisternum to the pubic symphysis	0	1
General inspection around bed for medication (e.g. metformin) and to see if patient appears comfortable	0	1
Inspects abdomen looking for symmetry of abdominal distension, surgical scars (e.g. pfannestiel scar or laproscopic scar), eversion of the umbilicus, linea nigra, striae gravidarum, striae albicans, any foetal movements)	0	1
Asks patient if they have any pain anywhere	0	1
Palpates abdomen making note of uterine size and measures symphysio-fundal height (tape measure down so blind measurement) comparing this to expected.	0	1	2
Palpates for liquor volume and comments on volume. Notes causes of reduced (dehydration, foetal abnormalities) or increased (gestational diabetes, foetal abnormalities) volume	0	1	2
Palpates foetus, identifying number present and lie (longitudinal, transverse, oblique)	0	1
If longitudinal, determines the presentation (cephalic or breech)	0	1
If longitudinal and cephalic, determines engagement quoting this in how many fifths are palpable	0	1
Ausculates over the anterior shoulder for the foetal heartbeat using Pinard stethhoscope. When auscultating, should not be holding pinard with hands and should be feeling maternal pulse	0	1
Checks for ankle/sacral oedema	0	1
Requests urinalysis and maternal blood pressure	0	1
Summarises appropriately with only key findings	0	1
Offers appropriate differential diagnoses and explains these to patient	0	1
Offers next steps according to guidelines (e.g. pre-eclampsia: senior review, whether to admit patient and give antihypertensives and whether to deliver baby)	0	1
Patient global score	0	1	2

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