Vaginal Examinations

Question 1

List TEN reasons that a vaginal examination should be undertaken

Answer 1

• To confirm the onset of labour
• To assess the progress during labour
• To identify position and presentation
• To perform an artificial rupture of the membranes
• To apply fetal scalp electrodes
• Undertake fetal blood sampling
• To determine cause of delay in labour
• Confirm full dilation of the cervix
• Prior to an instrumental delivery
• Exclude cord prolapse if SRM with high presenting part

Question 2

List SIX indications that a vaginal examination should NOT be undertaken

Answer 2

• No maternal consent
• Maternal distress
• In presence of bleeding
• Where there is known placenta praevia
• Premature rupture of membranes
• Premature birth (initial VE should be undertaken by obstetrician)

Question 3

List FIVE points to consider before and during a vaginal examination

Answer 3

• Informed consent
• Privacy / dignity
• Full or empty bladder
• Position and comfort of the woman
• Asepsis

Question 4

List SIX things that should be done prior to undertaking a vaginal examination

Answer 4

• Explanation to the women of what you are doing and why
• Gain consent
• Ensure privacy
• Wait for the woman to empty her bladder
• Always do an abdominal examination before
• Listen to the fetal heart

Question 5

Describe the cervix before the start of labour

Answer 5

Usually in a central or posterior position, firm and non-effaced with the cervical os tightly closed

Question 6

Describe the cervix in early labour

Answer 6

Structure and position changes, moving in to a more anterior position and feeling less rigid

Question 7

What FOUR things should you do after undertaking a vaginal examination?

Answer 7

• Ensure the woman’s comfort and dignity
• Auscultate the fetal heart
• Inform the woman of what you have found
• Document findings