Obstetric Exam

June 05, 2016 Print Friendly Version of this page Print Get a PDF version of this webpage PDF
Introduces self
0
1

Confirms name & age of patient
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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