pervaginal examination, vaginal examination, manually OBG procedure, during labour, for assessment of the progress of labour.

1. PER VAGINAL EXAMINATION
(PV)
PROCEDURE
PREPARED BY:
NIKITA SHARMA

2.  It is a examination done per vagina to assess
the status of vagina , cervix and progress of
descents of fetus through birth canal.
DEFINITION

3. PURPOSE
• To assess the progress and delay of
labour.

4. INDICATIONS
 At the onset of labour
 Progress of labour
 Following the rupture of membranes
 To diagnose beginning of 2nd stage of
labour

5. ARTICLES
Cap
Gloves
Plastic apron
Mask
Shoe cover
Lubricating jelly
Drawsheet sterile
Betadine solution
Gynaepad
Sponge holding forceps
Swabs
Sterile

6. PRE-PROCEDURAL
STEPS
PHYSICAL PREPARATION
 Give Loose gown to wear
 Remove pubic hair
 Bladder should be empty
 Provide perineal care to her
 Provide lithotomy position
PSYCHOLOGICAL PREPARATION
 Explain procedure to her
 Take informed consent
 Deep breathing during the procedure
 Relaxing of abdominal and perineal
muscles
 Ensurance of privacy

7. INTRA-PROCEDURAL
STEPS
Wear cap, mask and plastic apron

8. CONTINUE…..
DO SURGICAL HAND WASHING

9. CONTINUE…..
WEAR STERILE GOWN AND STERILE GLOVES

10. CONTINUE…..
PROVIDE DORSAL RECUMBANT POSITION
WITH LEGS FLEXED AT THE EDGE OF THE
EXAMINATION TABLE

11. CONTINUE…..
OBSERVE EXTERNAL GENITALIA FOR THE
FOLLOWING:
Vericosities, warts
& sores
Previous episiotmy
& laceration
Discharge &
bleeding
Show Color & odor of AF

12. CONTINUE…..
CLEASEN THE VULVA & PERINEAL AREA
WITH BETADINE SOLUTION

13. DRAPE THE PERINEAL AREA WITH STERILE
SHEET
CONTINUE…..

14. CONTINUE…..
HOLDING THE LABIAAPART FROM LEFT
HAND, INSERT RT. HAND GLOVED FINGER IN
TO THE VAGINA

15. NOTE THE FOLLOWING:
CONTINUE…..
VULVA:
• Buldging, soft
• stretchable
EFFACEMENT
• Taking up/ shortening of
cervix (0-100%)
DILATATION
• Gaping of internal os
• 0-10 cm

16. POSITION
• Central
• Lateral
FOREWATER
• PRESENT
• ABSENT
STATION OF HEAD
• Llevel of presenting part in r/t ischial spines
• Minus , plus
CONTINUE……

17. CONTINUE……
BAG OF MEMBRANES
• Intact
• Rupture
POSITION OF FETUS
• Anterior
• Posterior & Lateral
MOLDING
• Overlapping of cranial bones

18. CONTINUE……
PRESENTATIONS
VERTEX BREECH FACE BROW

19. CONTINUE……
At the completion of the examination, withdraw
the fingers from the vagina, take care to note the
presence of any blood or amniotic fluid.

20. CONTINUE……
Pubic angle: angle corresponds the fully abducted
thumb and index finger.

21. CONTINUE……
Transverse diameter of the outlet (TDA): admit the
knuckles of the clinched fist between the ischial
tuberosities.

22. POST-PROCEDURAL
STEPS
Clean and dry the perineal area and the buttocks
Give the sterile perineal pad if leakage
Remove gloves and wash hands
Remove gown and mask
Auscultate the FHR and mark on the patient chart

23. Shift her in bed and give left lateral position
Recoding and reporting
Inform the physician
Soiled cotton and gauze should be discarded in
yellow bin
Cleaning and replacement of the articles.
CONTINUE……

24.  Tell patient to inform any excessive bleeding after
procedure (a little bit bleeding is normal.)
• Instruct patient to follow up the procedure.
HEALTH EDUCATION