Examination Skills Flashcards
What is the first step in obstetric history taking?
Wash hands
What information should be confirmed at the beginning of obstetric history?
NAME, AGE, G+P, EDD/GA
What should be assessed regarding the patient’s pregnancy?
Single or multiple pregnancy, ethnicity of patient
What are key symptoms to ask about in obstetric history?
PV bleeding, contractions, pain, fluid loss or discharge, other problems with pregnancy
Symptoms of pre-eclampsia: H/A visual disturbances,
epigastric pain, oed
What symptoms indicate potential pre-eclampsia?
H/A, visual disturbances, epigastric pain, oedema
What does HOPC stand for in obstetric history?
History of Presenting Complaint
What Acronym should be considered in HOPC?
SOCRATES
What investigations should be confirmed in the current pregnancy?
Rh group, GBS, anomaly scan, etc.
What is included in past obstetric history?
List previous pregnancies in order, sex, mode of delivery, neonatal outcomes
What are some issues to note in past obstetric history?
- Miscarriages and stillbirths
- Preterm delivery
- Early onset preeclampsia
- Abruption
- Small for date (SFD) or macrosomia
- GDM
What aspects are covered in past gynecological history?
- Contraception
- Smear – when and result
- Any conditions or operations
- Recurrent STI or PID
What can maternal diabetes cause in pregnancy?
- Macrosomia
- Foetal growth restriction (FGR)
- Congenital abnormality
- Pre-eclampsia
- Stillbirth
- Neonatal hypoglycaemia
What risks are associated with hypertension in pregnancy?
Pre-eclampsia
What are some conditions that may worsen renal disease during pregnancy?
- Worsening renal disease
- Pre-eclampsia
- FGR
- Preterm delivery
What is the significance of HIV in pregnancy?
Vertical transmission
What should be confirmed during obstetric examination?
NAME, AGE, G+P, GA
What should be assessed during abdominal inspection?
- Distension
- Shape
- Foetal movements
- Contour
- Skin changes
What are Leopold’s manoeuvres used for?
Palpating the position of the fetus
What does Nagle’s Rule calculate?
Estimated Due Date (EDD)
What defines macrosomia?
≥4500 grams
What defines small for date (SFD)?
<10th centile
What causes large symphysial-fundal height (SFH)?
- Inaccurate measurement
- Multiple pregnancy
- Macrosomia
- Polyhydramnios
- Wrong dates
What causes small SFH?
- Inaccurate measurement
- IUGR
- Oligohydramnios
- Foetal descent into pelvis
What is the first step in post-natal history taking?
Wash hands
What should be confirmed in post-natal history?
NAME, AGE, Parity ONLY, GA at delivery
What are the potential symptoms to assess post-natally?
- Pain
- Bleeding
- Temperatures
- Discharge
- Perineal discomfort
- Pain in legs/chest
- Mood
What is included in the mode of delivery assessment?
- Vaginal delivery – spontaneous or induced, instrumental
- C-section – elective or emergency
What should be assessed during the post-natal examination?
- General inspection
- Abdominal inspection
- Palpation
- Percussion and auscultation for bowel sounds
- Check limbs for oedema
What is a common duration of hospital stay for vaginal delivery?
1-2 days
What is a common duration of hospital stay for cesarean section?
4-5 days
What is a common post-partum abdominal distension caused by?
Gas/constipation
