vaginal examinations Flashcards
1
Q
why are vaginal examinations performed
A
- Confirm onset of labour
- Diagnose presentation
- Prior to analgesia administration
- Perform ARM
- assess progress in labour
- Assess condition of cervix
- Concerns for Fetal well being
- Apply FSE
- To administer remove medication
- Decision around MOB
- Emergency
- Perform membrane sweep
2
Q
what is assessed in a vaginal examination
A
- Vulva
- Vagina
- Cervix
- Fetus
Other
3
Q
vulva and vagina
A
- Varicosities
- Infection `
- Oedema
- Scars
Warts
4
Q
cervix
A
you would check for
Position - posterior , mid and anterior
Consistency - firm , softening and soft
Application - well and loose
5
Q
effacement
A
Long
Effaced
Fully effaced
Partially effaced
Oedematous
6
Q
Cetus presentation
A
- Breech
- Face
- Brow
- Vertex
Shoulder
7
Q
fetus attitude
A
- Flexed
- Deflexed
- Extended
- Hyper extended
8
Q
position
A
Position
Relationship of denominator to the 8 key points of the pevic brim
Occiput
Mentum
Sacrum
9
Q
moulding
A
Moulding
0+
1+
2+
3+
10
Q
caput
A
Caput
0+
1+
2+
3+
11
Q
membranes
A
- Present
- Absent
- Well applied
Bulging
12
Q
cord prolapse
A
cord protruding through the cervix - membranes absent
13
Q
When are vaginal examination contraindicated
A
- No consent
- Placenta praevia
- Active bleeding
- Pre labour rupture of membranes
- Pre term pre labour rupture of membranes
- Suspected pre term labour
- Obvious signs of placental abruption
14
Q
how do you prepare for a ve
A
- Check notes
- Empty bladder
- Ensure informed consent , privacy , dignity and comfort
- Gather equipment - consider if ve pack is needed
- Abdominal palpation and auscultation
- Semi recumbent position
- As relaxed as possible
Done ppe and prepare sterile gloves
15
Q
what is the process of a vaginal examination
A
- If using VE packs wipe vulva front to back
- Lubricate first 2 gloved fingers of dominant hand
- Part labia & insert 2 fingers (downwards and backwards)
- Ensure thumb doesn’t come into contact with clitoris or anus
- Consider your facial expressions
- Feel for cervix
- Remove fingers gently
- Remove gloves , removed soiled pad , cover with sheet
Auscultate Fetal heart
16
Q
what are the findings of vaginal examinations
A
- Correlate findings of abdominal palpation & vaginal examination
- Explain findings and possible impact on birth plan
- Provide reassurance where possible
- Document - justification , consent , procedure , findings , discussions and actions
- Further plan
Escalate accordingly
17
Q
what are the risks involved
A
- Invasive and intimate
- Painful
- Measurements subjective
- Inconsistency between practitioners
- Accidental rupture of membranes
- May disrupt concentration
- May require position change
May increasing feelings of vulnerability
