Vaginal Examinations Flashcards
Why are vaginal examinations performed?
During early labour, routine vaginal examinations are undertaken at regular time intervals (generally every 4 hours), this provides information on how dilated the cervix is and the position of the baby
How often are vaginal examinations performed when a woman is in early labour?
Generally every 4 hours
What information can be found by performing a vaginal examination?
- Confirm onset of labour
- Condition of cervix (dilation, softening, effacement)
- Concerns for fetal wellbeing
- Assess process in labour
- Diagnose presentation
What terminology for the cervix used during a vaginal examination?
Position – posterior, mid, anterior
Consistency – firm, softening, soft
Application – well, loose
Effacement – long, effacing, partially effaced, fully effaced, oedematous
Dilation – 1cm – 10cm
What terminology for the fetus is used during a vaginal examination?
Presentation - breech, face, brow, vertex, shoulder
Attitude – flexed, deflexed, extended, hyper-extended
Position – relationship of denominator to the 8 key points of pelvic brim – occiput (occipito), mentum (mento), sacrum (sacro)
Station – relationship of presenting part of ischial spines (cm)
Moulding – 0+, 1+, 2+, 3+
Caput – 0+, 1+, 2+, 3+
What other terminology is used during a vaginal examination?
Membranes – present, absent, well applied, bulging
Cord prolapse – cord protruding through the cervix – membranes absent
Odour – possible infection
Vaginal loss – blood streaking, thrush, meconium
What are some reasons why a vaginal examination should not be performed?
- No consent
- Placenta praevia
- Active bleeding
- Pre-labour rupture of membranes
- Suspected pre-term labour
What are the 4 stages to performing a vaginal examination?
- Discussion
- Preparation
- Examination
- Findings
What are 5 risks associated with vaginal examinations?
- Invasive and intimate
- Sometimes painful
- Measurement subjective
- Inconsistency between practitioners
- Accidental rupture of membranes
