| Details | Obstetric Examination – Key Points
Preparation: Gain informed consent, ensure privacy and comfort, Ask the woman to empty her bladder, Position in semi-recumbent or supine position (avoid lying flat late in pregnancy) and expose the abdomen and lower chest, draping appropriately
General Examination
Appearance: Alertness, pallor, jaundice, distress
Vital signs: Pulse, blood pressure, respiratory rate, temperature
Oedema: Face, hands, legs
Fundal height vs. gestational age consistency
Inspection of hands: Palmar erythema, nails, tremors
Abdominal Examination
Inspection
Shape and size of the abdomen
Skin changes: Striae gravidarum, linea nigra, surgical scars
Fetal movements (may be visible)
Umbilicus: Flat, everted
Symmetry
Palpation
Fundal Height
Measure from pubic symphysis to fundus (in cm)
Should roughly correlate with gestational age after 20 weeks
Fundal Palpation
Determine which fetal pole is in the fundus (e.g., breech or head)
Lateral Palpation (Leopold’s 2nd maneuver)
Palpate both sides to determine fetal back and limbs
Pelvic Palpation (Lower pole)
Check for the presenting part
Is it engaged?
Pawlik’s Grip
Used to assess engagement and mobility of the presenting part
Auscultation
Use fetoscope or Doppler to listen for fetal heart rate
Normal: 110–160 bpm
Note rate, rhythm, and presence
Vaginal Examination (If indicated)
In labour to assess cervical dilation, effacement, station
In third trimester for presentation if unclear by palpation
Avoid if there is PV bleeding until placenta previa is ruled out
Additional Systems (if indicated)
CVS: Murmurs, heart rate
Respiratory: Breath sounds, respiratory distress
Breasts: Inspect and palpate in late pregnancy
Document Findings
Include:
Fundal height (cm)
Lie (longitudinal, oblique, transverse)
Presentation (cephalic, breech)
Position (e.g., LOA, ROA)
Engagement
|
|---|