Examination of Obstetric Patient

Common physical examination questions in O & G is 

Q1. Show me  how would you asses for anaemia

Q2. Examination the Abdomen 

Below is a sample of how to both the the examinations 

Q1. Assessing for anaemia  in pregnant

This picture taken from Google search . Thank you for this nice picture. It’s for teaching purposes only. 

• Wise greetings to pt. Check pts name 
• Introduce yourself & others including the lecture to pt 
• Get a cepharone
• Wash your hands 
• Explain to patient, madam/ Pn I would like to examine your hand/ conjunctiva & moth to look for any signs of anaemia 
• Please show me your hands check one hand is fine. Choose a free hand. If the hand has drip or branula, than avoid this hand & don’t cause pain or hurt the patient 
• Hands: Check the color of the palms and capillary refill time ( should be less than 2  sec)
• Findings: The palms are pink, and capillary refill time is less than 2 seconds.

• Note any koilonychia (signs of chronic anemia).
• Than say madam / Pn now I would like to check your eyes/ conjunctiva. One eye is fine.
• The Conjunctiva: Check one side for signs of anemia.
• Findings: Conjunctiva is pink / pale.
• Finally madam / Pn , l would like to check our lips/ and tongue . 
• The Lips: Observe for color.
• Findings: Lips are pink / pale.
• The Tongue: Ask the patient to open their mouth and stick out their tongue.
• Findings: The tongue is pink, and there is no glossitis. The us no angular stomatitis - both indicate chronic anaemia 

FINALLY TELL THE EXAMINER WHETHER THERE IS ANAEMIC OR NOT IN THIS PATIENT 

most of the time the examiner will ask few questions pertaining to anaemia

• What is the normal value of  haemoglobin in pregnancy. > 11g% 
• What are the causes of anaemia : Nutritional anaemia, chronic blood loss, haemoglobinopathies, myeloproliferative disorder, aplastic anemia & idiopathic causes . 

Q2. Examine the abdomen? 

INTRODUCTION TO ABDOMINAL EXAMINATION
1. Greet the patient and ask for permission to proceed.

2. Apply hand sanitizer.

3. Get a cepharone 

Tell patient, I would like to examine your abdomen, please let me know if there is any pain or discomfort. Thank you for your cooperation. 

On my in INSPECTION
• The Abdomen: It is distended due to the gravid uterus, which is evidenced by the presence of linea nigra and striae gravidarum.

• The Umbilicus: is Inverted / everted, centrally placed, and flat.
• look for any Scars: Note any scars. If present, assess the length and check for any rebound tenderness. Or ask patient to cough and see if there is hernia 
•  There is some Hyperpigmentation: Present / not present.
• if can see fFetal Movement: Visible / not visible. 

ON MY PALPATION. 
1. Begin with light palpation, observing the patient’s facial expressions.
• Findings: The abdomen is soft / firm and non-tender / tender.
2. Symphysis-Fundal Height: Measure the height by locating the fundus, marking it, and measuring down to the pubic symphysis.

Example finding: 33 cm. The SFH is 33 cms and if know the POA can say it’s Co response with the POA 

3. Proceeds with LEOPOLD’S MANEUVERS

Perform the maneuvers in the following order: fundal grip, lateral grip, pelvic grip, liquor estimation, and estimated fetal weight grip.
Key Points to Note:
• No pain during palpation.
• Singleton fetus (if non-twin pregnancy).
• Fetal lie: longitudinal / transverse.
• Fetal movement: palpable / not palpable.
• Fetal back is on the maternal right / left.
• Fetal head: engaged / non-engaged (specify if palpable).
• Liquor: adequate.
• Estimated fetal weight: approximately ____ g.
• Symphysis-fundal height is ____ cm and is consistent / smaller / greater with the gestational age of ____

4. AUSCULTATION
• Complete the examination by listening for the fetal heartbeat.

SUMMARY
In Summary: My patient, (Name), (Age) years old, Gravida ___ Para ____, at ………. POA/ POG presented with (chief complaint). & issues

MAIN ISSUE: PPROM

She also has risk factors 

1. Previous Lscs

2. GDM on diet control

3. Mild Anaemia latest Hb- 10.8g%

Findings: (Summarize key examination findings).
This script ensures clarity and maintains the professional flow of a comprehensive obstetric examination. 

TIPS : STUDENTS MUST PRACTICE EXAMINATIONS & PRACTICE PRESENTATION REPEATEDLY TO GET THE FLOW IN ORDER