Basic procedures in OB.

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Presentation transcript:

Basic procedures in OB

Basic procedures in OB Leopold maneuver Pelvic exam & pelvimetry assessment Normal delivery

Leopold maneuver

Leopold maneuver - Evaluate Hx - Empty bladder - Inform patient - Convenient/private room

Leopold maneuver

Leopold maneuver First Leopold maneuver Palpation of uterine fundus

Determine small parts and large part Leopold maneuver Second Leopold maneuver Determine small parts and large part

Leopold maneuver Third Leopold maneuver Fetal presentation and engagement

Leopold maneuver

Leopold maneuver Fourth Leopold maneuver Fetal engagement

Pelvic exam & pelvimetry assessment

Pelvic exam & pelvimetry assessment Cervical dilatation Effacement Membrane intact or rupture Station Presentation

Pelvic exam & pelvimetry assessment

Pelvic exam & pelvimetry assessment Station

Pelvic exam & pelvimetry assessment Clinical pelvimetry Pelvic inlet Mid pelvis Pelvic outlet

Pelvic exam & pelvimetry assessment

Pelvic exam & pelvimetry assessment

Pelvic exam & pelvimetry assessment Pelvic inlet Normal obstetric conjugate diameter 10 cm. Normal diagonal conjugate diameter 11.5 cm.

Pelvic exam & pelvimetry assessment

Pelvic exam & pelvimetry assessment Mid pelvis Normal ischial spine diameter 10 cm. No prominent of ischial spine Parallel pelvic side wall

Pelvic exam & pelvimetry assessment

Pelvic exam & pelvimetry assessment Pelvic outlet Subpubic angle > 90 degree Interischial tuberosity > 8 cm.

Normal delivery

Normal delivery Patients Obstetrician Lithotomy Observe FHR, uterine contraction Check BP Scrub Obstetrician Wear mask, gogle, booth, plastic sheath Washing, scrub hands Wear sterile gown & surgical gloves

Normal delivery

Normal delivery

Normal delivery

Normal delivery

Normal delivery

Normal delivery Crowning

Normal delivery Save perineum Modified Ritgen maneuver

Clear secretion in oropharynx Normal delivery Clear secretion in oropharynx

Normal delivery Shoulder delivery Pulling downward until delivery of anterior shoulder then pulling upward

Normal delivery Cord clamping and cutting

Normal delivery Delivery of placenta Technique Control cord traction Modified Crede’ maneuver Brunt andrew maneuver Sign of placental separation Uterine sign Cord sign Vulvar sign

Normal delivery Placental checking Maternal side

Normal delivery Placental checking Fetal side

Repair episiotomy wound

Repair episiotomy wound Wound checking Cervix Vagina and introitus Episiotomy wound Rectum

Repair episiotomy wound

Repair episiotomy wound