Vaginal Examination Flashcards
1
Q
Explain the process of the vaginal examination
A
- Carry out abdominal palpations incl fetal heart to determine the lie and the presenting part of the fetus
- Remove underwear and cover bottom half with blanket/sheet to maintain her privacy
- Apply ppe on to reduce time woman is in position
- Position woman: recumbent position, knees bent, ankles together and place sheet underneath her bottom. Ask for consent again. Document if alternative position is used
- Lubricate forefingers of dominant hand
- Inspect general genital region including labia, clitoris, discharge - consider infection/scars/trauma/cysts/inflamation
- With non-dominant hand part labia and observe condition
- When mother is ready, gently place two fingers of examining hand into vagina in a downwards and backward direction along the anterior vagina wall - ensure thumb does not contact the anus or clitoris
- Locate the cervix and determine the: position, degree of effacement, dilation, application of presenting part
- Move the fingers through the cervical os to ascertain the presence of: fore waters/membranes, presentation, position 12 o’clock at the top under symphysis pubis and 6 o’clock at the sacrum
- Degree of flexion
- Level of presenting part
- Exclude cord or placenta
- Be aware of passage - pelvis shape/structures
- Keep still if contractions come
- Withdraw fingers gently, Remove gloves, Ausculate the fetal heart rate remember post clinical actions and discussion
- Wash hands
2
Q
Explain what you would do prior to the vaginal examination
A
- Wash hands
- Introduce yourself&role. Confirm name and dob. Explain examination and gain consent
- Ask if there is any concerns
- Ensure privacy and dignity is maintained
- Gather equipment: clean and sterile gloves, apron, lubricant, disposable sheet and clean trolley/surface
- Ask her to empty her bladder