Obstetric Examination Flashcards
How should a patient be exposed for an obstetric exam?
From below the breasts to pubic bone
What position should an obstetric patient be in for examination?
Lie on a low pillow if early pregnancy
Left lateral position with more pillows if later in pregnancy
What should be inspected for in an obstetric examination?
Scars
Striae gravidarum
Linea nigra
How should you stand when palpating the pregnant abdomen?
Stand facing the patient
How is the pregnant abdomen palpated?
Use both hands
Flex fingers gently
What are you palpating for during pregnant abdomen examination?
Upper and lateral edge of mass
Two fetal poles (head and breech) to assess lie
Find the highest point of the uterus (fundus) using the side of the hand
What should be done after palpating the pregnant abdomen?
Measure fundal height (only possible after 20 weeks)
How is fundal height measured?
Point tape measure facing down the way
Measure from fundus down to pubic symphysis
Fundal height in cm = gestation in weeks
What should be done after measuring fundal height?
Feel for presenting part
How do you feel for the presenting part?
Place both hands at base of uterus, above pubic bone and ballot the head gently, or note if not possible
What should be done before feeling for the presenting part?
Warn the patient of possible discomfort
What should be done after feeling for the presenting part?
Feel for engagement
What is the purpose of feeling for engagement?
To feel how much of the head is still palpable in the abdomen
What should be done after feeling for engagement?
Auscultate for the fetal heart using a doppler
