Vaginal Examination

Question 1

List 10 reasons a vaginal examination may be indicated

Answer 1

• to confirm onset of labour
• to assess progress in labour
• to confirm position and presentation
• to determine cause of delay in labour
• to confirm full dilation of the cervix
• to perform an artificial rupture of membranes
• to apply a fetal scalp electrode
• to perform fetal blood sampling
• to check for cord prolapse if SROM while presenting part is high
• prior to instrumental birth

Question 2

List 8 things that should be done prior to a vaginal examination

Answer 2

• ask if the woman has had a vaginal examination before and address any concerns
• explain need for procedure
• explain what it entails
• gain informed consent
• ensure privacy
• encourage woman to empty her bladder
• perform an abdominal palpation
• ensure the woman knows the procedure may be stopped at any time

Question 3

List 6 contraindications to vaginal examination

Answer 3

• lack of maternal consent
• prelabour rupture of membranes
• unknown placental position
• placenta praevia
• preterm labour
  ? - bleeding

Question 4

List 5 things that are important during a vaginal examination

Answer 4

• informed consent
• privacy
• dignity
• maternal position and comfort
• asepsis

Question 5

List 4 things you should do after performing a vaginal examination

Answer 5

• assist woman into comfortable position
• auscultate the fetal heart
• communicate findings
• document findings

Question 6

List 5 elements that should be assessed during a vaginal examination

Answer 6

• external genitalia
• cervix
• membranes
• position and station of presenting part
• pelvic outlet