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Osce obstetrics for undergraduate

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Undergraduate course lectures in obstetrics and Gynecology Prepared by Dr Manal Behery Professor of OB&Gyne Faculty of medicine ,Zagazig University

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Osce obstetrics for undergraduate

  1. 1. DR: Manal Behery Zagazig University,Egypt 2014 DR: Manal Behery Zagazig University,Egypt 2014 OSCE Obstetrics EXAM
  2. 2. A B slide1
  3. 3. 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
  4. 4. Left occipto anterior
  5. 5. DOA DOP(face To Pubis)
  6. 6. Slide 2
  7. 7. • 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
  8. 8. Slide3
  9. 9. • What is the cord anomaly shown In this photo? • What is the possible complications of this condition ?How to diagnose this complication Slide3
  10. 10. slide4
  11. 11. 1- What does this graph show? 2- describe the type of abnormal couse you see 3- how would you manage this condition . slide4
  12. 12. History Of Partogram • Friedman's partogram •
  13. 13. A prolonged latent phase B prolonged active phase C arrest active phase Abnormal progress in labor
  14. 14. Philpott alert and action line
  15. 15. 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
  16. 16. 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
  17. 17. Normal labor progress • At addmision • Then after 4h
  18. 18. Abnormal labor progress
  19. 19. Obstructed labour Assessment: Powers Passenger Passages
  20. 20. Slide 5
  21. 21. • What is the name of this maneuver ?What is the indications? • What is the prerequisite ? • What is the complication ? Slide5
  22. 22. Slide 6
  23. 23. • 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
  24. 24. Rubin maneuver vs. bring post arm
  25. 25. • determine slide 7
  26. 26. • determine position in this photo? • What is the attiude of this fetus? • What is the mechnism by which head is delivered? slide7
  27. 27. slide8
  28. 28. 1. Describe the name of this CTG anomaly? 2. What is the cause ?and degrees 3. Mention additional CTG finding to consider an amnions trace Slide 8
  29. 29. Variable Deceleration
  30. 30. Slide 9
  31. 31. • what is the name of this instrument • what does it detect • what is the character of normal CTG trace Slide 9
  32. 32. Toco = uterine activity Fetal heart rate
  33. 33. Baseline rate Contractions Irregular 1-2:10 Variability = 20 bpm accelerations No decelerations
  34. 34. Baseline rate = 170-180 Variability = 5 No accelerations Contractions 4:10 Late decelerations
  35. 35. Slide 10
  36. 36. 1. What this image show? 2. What is the possible cause cause ? 3. What is the defferntial diagnosis? Slide 9
  37. 37. • ? Slide11
  38. 38. • What does this image show? • What is the cause of this problem ? • How to manage? Slide 11
  39. 39. Slide12
  40. 40. • 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
  41. 41. 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
  42. 42. Slide 13
  43. 43. • What is the name of this maneuver? • What is the indication ? • What is the prerequisite? • Name 2 complication Slide 13
  44. 44. Internal podalic version To do or not to do ??To do or not to do ??  Experienced operatorExperienced operator  EFW > 1500 gmEFW > 1500 gm  Adequate liquorAdequate liquor  Available anesthesia forAvailable anesthesia for effective uterine relaxationeffective uterine relaxation  Simultaneous preparationSimultaneous preparation for emergency C/Sfor emergency C/S
  45. 45. slide14
  46. 46. • What this image show? • What is the main cause of this abnormaility? • What is the complications?name 2 Slide 14
  47. 47. Slide 15
  48. 48. • What does this image show? • What is the complication of this method? • Name 2 other possible alternative methods Slide 15
  49. 49. Slide16
  50. 50. • 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
  51. 51. Slide17 A B
  52. 52. • What this photo show? • What is the risk factor? • What is the degree in A &B?what is the main complication ? A B Slide17
  53. 53. Answer
  54. 54. Slide18
  55. 55. • 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
  56. 56. slide19
  57. 57. • What does this picture show • What is the indication ? • What is the prerequisite? Slide 19
  58. 58. • ? Slide20
  59. 59. • What is the name of these 2 traingle? • How to define outlet contraction? • What is Thomas” dictum ? Slide20
  60. 60. An outlet with male pelvic character
  61. 61. Contracted vs. capacious outlet
  62. 62. Slide 21
  63. 63. • What is this maneuver ? • Why it is performed ? • How it is performed ? • What is the risk of sudden extension of fetal head? Slide 21
  64. 64. Slide 22
  65. 65. • What is cause of this emergency situation • Give 2 diagnostic signs • Give 4 factors affecting prognosis of this condition? Slide 22
  66. 66. Diagnosis Cord pulsations CTG shows variable decelerations  Fundal pressure causes bradycardia Meconium stained liquor
  67. 67. Slide 23
  68. 68. • What this image show ? • What is the cause ? How to diagnose this case antenatally? Slide 23
  69. 69. • What is the name of this maneuver ? • What is the indications • Name 2 complications Slide 24
  70. 70. • What is the name of this maneuver ? • What is the indications • Name 2 complications Slide 24
  71. 71. Slide 25
  72. 72. 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
  73. 73. Slide26
  74. 74. 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
  75. 75. Dichoronic vs. monochoronic
  76. 76. Slide 27
  77. 77. 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
  78. 78. Slide 28
  79. 79. • What is the placental anomaly shown In this photo? • What is the possible complications of this condition ?How to diagnose it antenatally? Slide28
  80. 80. Placenta succenteuriata: Complication 1. Retained placenta 2. Postpartum hemorrhage 3. peurpral sepsis Diagnosis 1. US and Doppler
  81. 81. Slide29
  82. 82. • What is the placental anomaly shown In this photo? • What is the possible complications of this condition ?How to diagnose it antenatally? Slide29
  83. 83. 1. Bipartite placenta Complication 1. Retained placenta 2. Postpartum hemorrhage 3. peurpral sepsis Diagnosis 1. US and Doppler
  84. 84. by Doppler :Bilobate placenta
  85. 85. Slide30
  86. 86. a)What this image show? b)What it this process called? c)How you detect it by PV ? Slide30
  87. 87. Slide31
  88. 88. 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
  89. 89. 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),
  90. 90. Slide 32
  91. 91. Slide 32 1)What is the name of this maneuver ? 2)What is the complication ?name 2 3)Name 2 other maneuver ?
  92. 92. Slide 33
  93. 93. • 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
  94. 94. a/r

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