1. Basic procedures in OB

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

3. Leopold maneuver

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

5. Leopold maneuver

6. Leopold maneuver
First Leopold maneuver
Palpation of uterine fundus

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

8. Leopold maneuver Third Leopold maneuver
Fetal presentation and engagement

9. Leopold maneuver

10. Leopold maneuver
Fourth Leopold maneuver
Fetal engagement

11. Pelvic exam & pelvimetry assessment

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

13. Pelvic exam & pelvimetry assessment

14. Pelvic exam & pelvimetry assessment
Station

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

16. Pelvic exam & pelvimetry assessment

17. Pelvic exam & pelvimetry assessment

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

19. Pelvic exam & pelvimetry assessment

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

21. Pelvic exam & pelvimetry assessment

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

23. Normal delivery

24. 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

25. Normal delivery

26. Normal delivery

27. Normal delivery

28. Normal delivery

29. Normal delivery

30. Normal delivery
Crowning

31. Normal delivery
Save perineum
Modified Ritgen maneuver

32. Clear secretion in oropharynx
Normal delivery
Clear secretion in oropharynx

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

34. Normal delivery
Cord clamping and cutting

35. 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

36. Normal delivery
Placental checking
Maternal side

37. Normal delivery
Placental checking
Fetal side

38. Repair episiotomy wound

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

40. Repair episiotomy wound

41. Repair episiotomy wound