7.) Obstetrical status , vaginal examination during labour

Question 1

What is the purpose of assessing obstetrical status during labour ?

Answer 1

its to monitor the progress of labour , evaluate fetal station , check for cervical changes , and ensure maternal and fetal well being

Question 2

How can we do a vaginal exam ?

Answer 2

It involves gently parting of the labia then inserting two gloved lubricated ( ky jelly) fingers usually the index and mid finger.

Question 3

What is cervical dilation ?

Answer 3

Measures the opening of the cervix (0cm closed) (10cm fully dilated)

Question 4

What is cervical effacement ?

Answer 4

Reffers to the thinning of the cervix expressed as a percentage from 0% (not thinned) to 100% which is completely thinned.

Question 5

What is fetal station ?

Answer 5

This indicates the position of the baby’s head relative to the mothers pelvis , with measurements ranging from -3 to +3 where 0 means the baby’s head is at the level of the ischial spines indicating engagement.

Negative numbers means the head is above the ischial spines.

positive numbers mean the head is below the ischial spines

Question 6

What is membrane status ?

Answer 6

Check if amniotic sac is intact or ruptured usually breaks around 4cm dilation , if ruptured the colour and odor of the amniotic fluid should be noted

Question 7

How often are vaginal exams performed during labour ?

Answer 7

Every 2 hours.

Question 8

What is the difference in primary para and multiparous in terms of the cervical dilation and effacement ?

Answer 8

In primary para first the cervical effacement occurs then the cervical dilation but for multiparous both occur at the same time

Question 9

What are the common positions of the cervix ?

Answer 9

• Posterior , closer to the sacrum.
• Mid , in the middle of the pelvic line.
• Anterior , closer to the symphysis pubis ( most favourable)

Question 10

Draw the graph for bishops score

Answer 10

Score 0-3 unfavourable cervix for labour.

Score 4-6 moderate ( consider cervical ripening to induce labour)

Score greater than or equal to 7 , favourable cervix , higher chances of successful vaginal delivery.

Question 11

if the score is less than 7 we have to consider what?

Answer 11

Cervical ripening methods like prostaglandins or mechanical ,dilation.

examples of prostaglandins are Dinoprostone or Misoprostol ( gel or oral)

Question 12

How does prostaglandins help ?

Answer 12

It promotes the softening , dilation , effacement of the cervix.