osce obstetrics for undergraduate
DESCRIPTION
Undergraduate course lectures in obstetrics and Gynecology Prepared by Dr Manal Behery Professor of OB&Gyne Faculty of medicine ,Zagazig UniversityTRANSCRIPT
DR: Manal BeheryZagazig University,Egypt
2014
DR: Manal BeheryZagazig University,Egypt
2014
OSCE Obstetrics EXAM
A Bslide1
A B• determine position in A and B?• What is the possible cause of this abnormaility ?
name 2• What is the enagaging diameter in B?
slide1
Left occipto anterior
DOA DOP(face To Pubis)
Slide 2
• What this image show?• What is the cause name 3 ?• What is the complication name 2?• What is the prefered mode of delivery and
why?
Slide 2
Slide3
• What is the cord anomaly shown In this photo?
• What is the possible complications of this condition ?How to diagnose this complication
Slide3
slide4
1- What does this graph show?
• 2- describe the type of abnormal couse you see
• 3- how would you manage this condition
.
slide4
History Of Partogram• Friedman's partogram•
A prolonged latent phaseB prolonged active phase
C arrest active phase
Abnormal progress in labor
Philpott alert and action line
Alert line ( health facility line )
• The alert line drawn from 3 cm dilatation represents the rate of dilatation of 1 cm / hour
• Moving to the right or the alert line means referral to hospital for extra care
Action line ( hospital line )• The action line is drawn 4 hour to the right of
the alert line and parallel to it• This is the critical line at which specific
management decisions must be made at the hospital
Normal labor progress
• At addmision • Then after 4h
Abnormal labor progress
Obstructed labour
Assessment:
Powers
Passenger
Passages
Slide 5
• What is the name of this maneuver ?What is the indications?
• What is the prerequisite ?• What is the complication ?
Slide5
Slide 6
• What is the name of this maneuver ?What is the indications?
• Briefly describe how it act?• Give name of other 2 maneuver to solve this
problem
Slide 6
Rubin maneuver vs. bring post arm
• determine
slide 7
• determine position in this photo?• What is the attiude of this fetus?• What is the mechnism by which head is delivered?
slide7
slide8
1. Describe the name of this CTG anomaly?2. What is the cause ?and degrees3. Mention additional CTG finding to consider
an amnions trace
Slide 8
Variable Deceleration
Slide 9
• what is the name of this instrument• what does it detect• what is the character of normal CTG trace
Slide 9
Toco = uterine activity
Fetal heart
rate
Baseline rate
Contractions
Irregular 1-2:10
Variability = 20 bpm
accelerations
No decelerations
Baseline rate = 170-180Variability = 5
No accelerations Contractions 4:10
Late decelerations
Slide 10
1. What this image show?2. What is the possible cause cause ?3. What is the defferntial diagnosis?
Slide 9
• ?
Slide11
• What does this image show?• What is the cause of this problem ?• How to manage?
Slide 11
Slide12
• What is the station of fetal head in this photo?• How to detect fetal station by PV?• What is the importance of• ischial spine level?
Slide 12
Ischial spin level station 0
• Above this level 1 ,2,3 cm • Station -1,-2,• -3(head abdominal (floating)
• Below this level 1,2,3 cm• Station +1,+2,• +3(head on perineum
Slide 13
• What is the name of this maneuver?• What is the indication ?• What is the prerequisite?• Name 2 complication
Slide 13
Internal podalic versionTo do or not to do ??To do or not to do ??
Experienced operatorExperienced operator EFW > 1500 gm EFW > 1500 gm Adequate liquorAdequate liquor Available anesthesia for Available anesthesia for
effective uterine relaxationeffective uterine relaxation Simultaneous preparation Simultaneous preparation
for emergency C/S for emergency C/S
slide14
• What this image show?• What is the main cause of this abnormaility?• What is the complications?name 2
Slide 14
Slide 15
• What does this image show?• What is the complication of this method?• Name 2 other possible alternative methods
Slide 15
Slide16
• What is the name of this graph ?what is the indication?
• Describe briefly mangment in zone 2,zone3• Give 2 other diagnostic test for this condition
Slide16
Slide17
A
B
• What this photo show?• What is the risk factor?• What is the degree in A &B?what is the main
complication ?
A
B
Slide17
Answer
Slide18
• What does this picture show• What is the chromsomal pattern of this
condition?• What is the treatment ?and how to follow up
after ttt
Slide 18
slide19
• What does this picture show• What is the indication ?• What is the prerequisite?
Slide 19
• ?
Slide20
• What is the name of these 2 traingle?• How to define outlet contraction?• What is Thomas” dictum ?
Slide20
An outlet with male pelvic character
Contracted vs. capacious outlet
Slide 21
• What is this maneuver ?• Why it is performed ?• How it is performed ?• What is the risk of sudden extension of fetal
head?
Slide 21
Slide 22
• What is cause of this emergency situation• Give 2 diagnostic signs • Give 4 factors affecting prognosis of this
condition?
Slide 22
DiagnosisCord pulsations
CTG shows variable decelerations Fundal pressure causes bradycardiaMeconium stained liquor
Slide 23
• What this image show ?• What is the cause ?How to diagnose this case antenatally?
Slide 23
• What is the name of this maneuver ?• What is the indications• Name 2 complications
Slide 24
• What is the name of this maneuver ?• What is the indications• Name 2 complications
Slide 24
Slide 25
1. What are 1, 2 ,3 ?2. Which one is the most important
obstetrically and what’s its length?3. What are 4 and 5?
Slide25
Slide26
1. What do you see in this photo ?2. What type of zyogsitiy?3. What is the choroncity? How to determine
it antenatal? And postnatal
Slide26
Dichoronic vs. monochoronic
Slide 27
1. What condition shown in this photo?2. What type a,b,c?3. What cause type e ?4. How to diagnose type D&e?
Slide27
Slide 28
• What is the placental anomaly shown In this photo?
• What is the possible complications of this condition ?How to diagnose it antenatally?
Slide28
Placenta succenteuriata:Complication 1. Retained placenta2. Postpartum hemorrhage3. peurpral sepsisDiagnosis 1. US and Doppler
Slide29
• What is the placental anomaly shown In this photo?
• What is the possible complications of this condition ?How to diagnose it antenatally?
Slide29
1. Bipartite placenta
Complication 1. Retained placenta2. Postpartum hemorrhage3. peurpral sepsisDiagnosis 1. US and Doppler
by Doppler :Bilobate placenta
Slide30
a)What this image show?b)What it this process called?c) How you detect it by PV ?
Slide30
Slide31
a)What is the name of this instrument b)What it is indication for its use?c) What are the possible complications of this
procedure ?
Slide31
Answer a)Amniotic hook/(amniotic membrane perforator)
b)Amniotomy (artificial rupture of membrane)
c)Cord prolaps• Trauma to genital tract or LS of uterus, • Intrauterine infection,• Abruptio placenta (if sudden rupture in
polyhydramnios),
Slide 32
Slide 32
1)What is the name of this maneuver ?
2)What is the complication ?name 2
3)Name 2 other maneuver ?
Slide 33
• What are these 4 maneuvers• What is value of a,• What is value of b• What is value of c• What is value of d
Slide 33
a/r