The obstetric examination is a type of abdominal examination performed in pregnancy. It is unique in the fact that the clinician is simultaneously trying to assess the health of two individuals – the mother and the fetus.
What is obstetric abdominal examination?
What is abdominal examination in pregnancy? Introduce yourself and clarify the patient's identity. Try and put mum at ease. Perform a general inspection of mum and her bump. Measure fundal height. Check the lie of the baby by examining her bump. Check the presentation of the baby to determine which ...
How do you ask for an abdominal exam during pregnancy?
Obstetric abdominal examination frequently appears in OSCEs and you’ll be expected to pick up the relevant clinical signs using your examination skills. This obstetric abdominal examination OSCE guide provides a clear step-by-step approach to examining the pregnant abdomen, with an included video demonstration.
What is included in the physical exam of a pregnant woman?
Mar 26, 2019 · Gently palpate the abdomen to assess the lie of the fetus (it should be longitudinal). If not, and the pregnancy is 36... Using to hand, palpate the abdomen and pelvic area to identify the presenting part. After 37 weeks, especially in a prim gravida assess if the fetal head is engaged. If not, ask ...
What are the signs of pregnancy on the abdomen?
Nov 12, 2018 · In the obstetric examination, inspect the abdomen for: Distension compatible with pregnancy Fetal movement (>24 weeks) Surgical scars – previous Caesarean section, laproscopic port scars Skin changes indicative of pregnancy – linea nigra (dark vertical line from umbilicus to the pubis), striae ...
Why do we do abdominal examination in pregnancy?
The examiner grasps the lower portion of the abdomen, just above the symphysis pubis, between the thumb and fingers of one hand. The objective is to feel for the presenting part of the fetus and to decide whether the presenting part is loose above the pelvis or fixed in the pelvis.
How do you perform the abdominal examination of the pregnant mother?
Procedure StepsIntroduce yourself and clarify the patient's identity. ... Try and put mum at ease. ... Perform a general inspection of mum and her bump. ... Measure fundal height. ... Check the lie of the baby by examining her bump. ... Check the presentation of the baby to determine which end of the baby is “presenting”.More items...•Sep 17, 2017
What is the purpose of abdominal examination?
The purpose of the abdominal exam is to get more information that could indicate what is causing the patient's symptoms. The physician gains information by inspecting, auscultating, palpating, and percussing the abdomen.
How do you perform an abdominal examination?
The abdomen is inspected by positioning the patient supine on an examining table or bed. The head and knees should be supported with small pillows or folded sheets for comfort and to relax the abdominal wall musculature. The entire abdominal wall must be examined and drapes should be positioned accordingly.
Why do doctors touch your stomach?
Pressing on your stomach is a way to find out if the size of your internal organs is normal, to check if anything hurts, and to feel if anything unusual is going on. Looking, listening, and feeling are all part of a physical exam.
What are the 4 parts in order for abdominal assessment?
Always follow this sequence: inspection, auscultation, percussion, and palpation. Changing the order of these assessment techniques could alter the frequency of bowel sounds and make your findings less accurate.
What should be included in an abdominal assessment?
With abdominal assessment, you inspect first, then auscultate, percuss, and palpate. This order is different from the rest of the body systems, for which you inspect, then percuss, palpate, and auscultate.
Should abdomen be firm or soft?
Normal: Abdomen is soft, rectus muscle is relaxed and no discomfort is elicited during palpation.
What is the difference between light and deep Palpations?
Light palpation depresses the abdomen to a depth of about 1 cm. It is often performed first and is used to detect tenderness in a particular region or quadrant. Deep palpation depresses the abdomen to a depth of about 4–5 cm. It is often performed second and is used to detect masses and organomegaly.Feb 5, 2021
What does a normal abdomen feel like?
Percussion of the abdomen A generally resonant abdomen suggests much flatus whilst solid or liquid under the fingers will be dull. Sometimes it is helpful to use percussion to define the edge of the liver.Oct 7, 2021
Where is your abdominal?
The abdomen (commonly called the belly) is the body space between the thorax (chest) and pelvis. The diaphragm forms the upper surface of the abdomen.Jul 9, 2020
How to tell if you are pregnant?
It is important to inspect the abdomen for pregnant signs such as: 1 Linea nigra: A dark vertical line running along the midline of the abdomen) 2 Striae gravidarum: Stretch marks on the abdomen due to the sudden weight gain of pregnancy 3 Striae albicans: Silvery-white stretch marks indicative of a previous pregnancy, where old stretch marks have since changed colour.
What are the dark lines on the abdomen?
Linea nigra: A dark vertical line running along the midline of the abdomen) Striae gravidarum: Stretch marks on the abdomen due to the sudden weight gain of pregnancy. Striae albicans: Silvery-white stretch marks indicative of a previous pregnancy, where old stretch marks have since changed colour.
What is the most common liver disease during pregnancy?
Also known as obstetric cholestasis, it is the most common liver disease of pregnancy. The aetiology is thought to be multifactorial due to the cholestatic effect of oestrogen. Obstetric cholestasis is characterised by pruritis (severe itching of the skin) in the absence of a rash.
What is the name of the condition that is a sign of pre-eclampsia?
Face. Look in the eyes for conjunctival pallor (anaemia) and jaundice (intrahepatic cholestasis of pregnancy or hepatitis). Check for oedema of the face (a sign of pre-eclampsia). Intrahepatic cholestasis of pregnancy. Also known as obstetric cholestasis, it is the most common liver disease of pregnancy.
When does gestational diabetes develop?
Gestational diabetes is diabetes which develops after the 20th week of pregnancy. It is likely to develop in patients with multiple risk factors for it. The foetus tends to be large for gestational age as a result of foetal pancreatic islet cell hyperplasia, leading to foetal hyperinsulinaemia and fat deposition.
Why do you put curtains on when pregnant?
You may the curtains to give the patient privacy as they get ready. Aortocaval compression. When a pregnant woman, especially those >20 weeks gestation, lies on her back, there is a risk of the pregnant uterus compressing the abdominal aorta and inferior vena cava.
What causes a large for gestational age?
There are a number of causes including a familial cause, obesity and most importantly gestational diabetes. Gestational diabetes is diabetes which develops after the 20th week of pregnancy.
What is obstetric cholestasis?
Obstetric cholestasis is a multifactorial condition that is characterised by abnormal liver function tests, jaundice and intense pruritis (typically affecting the palms and soles of the feet). The disease usually presents in the third trimester and is associated with an increased risk of intrauterine death and premature delivery.
What is the dark line running down the middle of the abdomen?
Linea nigra: a dark line running vertically down the middle of the abdomen (a normal finding in pregnancy). Striae gravidarum: reddish or purple lesions that develop due to overstretching of the abdominal skin as the gravid uterus expands (commonly referred to as stretch marks).
What is fetal lie?
Fetal lie refers to the relationship between the long axis of the fetus with respect to the long axis of the mother. Assess the gravid uterus to determine the fetal lie: 1. Place your hands on either side of the patient’s uterus (ensuring you are facing the patient). 2.
When is a fetus engaged?
A fetus is considered ‘engaged’ when more than 50% of the presenting part (usually the head) has descended into the pelvis. The fetal head is divided into fifths when assessing engagement: If you are able to feel the entire head in the abdomen, it is five fifths palpable (i.e. not engaged).
What is an obstetric exam?
Obstetric Examination. The obstetric examination is a type of abdominal examination performed in pregnancy. It is unique in the fact that the clinician is simultaneously trying to assess the health of two individuals – the mother and the fetus.
When should uterus be palpable?
Uterus should be palpable after 12 weeks, near the umbilicus at 20 weeks and near the xiphisternum at 36 weeks (these measurements are often slightly different if the woman is tall or short). The distance should be similar to gestational age in weeks (+/- 2 cm).
How to palpate a fetus?
Facing the patient’s head, place hands on either side of the top of the uterus and gently apply pressure. Move the hands and palpate down the abdomen. One side will feel fuller and firmer – this is the back. Fetal limbs may be palpable on the opposing side.
Where to palpate a fetal head?
If breech presentation is suspected, the fetal head can be often be palpated in the upper uterus. Ballot head by pushing it gently from one side to the other.
What is differential diagnosis for abdominal pregnancy?
Differential diagnosis. Depending on gestational age the differential diagnoses for abdominal pregnancy include miscarriage, intrauterine fetal death, placental abruption, an acute abdomen with an intrauterine pregnancy and a fibroid uterus with an intrauterine pregnancy .
What is primary abdominal pregnancy?
A primary abdominal pregnancy refers to a pregnancy that first implanted directly in the peritoneum, save for the tubes and ovaries; such pregnancies are very rare, only 24 cases having been reported by 2007.
Why is abdominal pregnancy considered a model of human male pregnancy?
Because pregnancy is outside the uterus, abdominal pregnancy serves as a model of human male pregnancy or for females who lack a uterus, although such pregnancy would be dangerous. Abdominal pregnancy has served to further clarify the disease pre-eclampsia which was previously thought (1980's) to require a uterus for it to occur, however pre-eclampsia's occurrence in abdominal pregnancy (with the conceptus outside the uterus) helped throw light on pre-eclampsia's etiology. Cases of combined simultaneous abdominal and intrauterine pregnancy have been reported.
What are the symptoms of a pregnancy?
Signs and symptoms. Symptoms may include abdominal pain or vaginal bleeding during pregnancy. As this is nonspecific in areas where ultrasound is not available the diagnosis was often only discovered during surgery to investigate the abnormal symptoms. They are typically diagnosed later in the developing world than the developed.
What is the treatment for a fetus?
Potential treatments consist of surgery with termination of the pregnancy (removal of the fetus) via laparoscopy or laparotomy, use of methotre xate, embolization, and combinations of these.
What are the risk factors for ectopic pregnancy?
Risk factors are similar to tubal pregnancy with sexually transmitted disease playing a major role; however about half of those with ectopic pregnancy have no known risk factors (which include damage to the Fallopian tubes from previous surgery or from previous ectopic pregnancy, and tobacco smoking ).
When to perform laparotomy?
It is generally recommended to perform a laparotomy when the diagnosis of an abdominal pregnancy is made. However, if the baby is alive and medical support systems are in place, careful watching could be considered to bring the baby to viability. Women with an abdominal pregnancy will not go into labor.
