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:: Gravida gravida :: April 15, 2007

Posted by Minci 先生 in Medical School.
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 We visited a friend of ours who was pregnant to practice palpating a pregnant abdomen for our exams. We were undoubtedly excited to see her – someone we know, of the same age, and is pregnant! We are not even married yet. HAHA.

She was a pretty sight. She had that ‘glow’. The mother glow. She was 38 weeks in her pregnancy but still she shines! And we all so want to be like her too despite the gruesome descriptions of pregnancy pains and symptoms. AND she played the role as our patient pretty well. HAHA.

The idea of this practice is to standardize our approach to the examination with the hope of obtaining full marks for this station – if we ever get them. This is by taking bits and pieces of everybody’s ‘ good style’ into one exam-orientated approach. Here is what we finally came up with;

  1. Introduce as medical student and seek consent to examine abdomen. Explain what I want to do.
  2. Check patient’s identity and gestational age.
  3. Tell the patient to expose her abdomen whilst I wash my hands/rub hands with alcohol gel.
  4. Enquire patient if she is happy with the baby’s movement, general wellbeing and if there’s any pain/tenderness/tightness on her abdomen. Remind the patient to inform me if the examination gets too uncomfortable, so as it could be stopped.
  5. Start with looking at the mother’s wellbeing in general and comment as necessary. If mother’s comfortable while lying down/in pain? Does she use a crutch?
  6. Inspect abdomen : Symmetrical distension of abdomen consistent with pregnancy, linea nigra, striae gravidarum/albicans, scars. 
  7. Then only start palpating. Measure FSH.
  8. Feel for fetal poles, the ‘lie’ (longitudianl, transverse,oblique?) and presentation (cepahalic, breech?). Know which side is the back. If unsure, try asking mother on which side does she usually feel the baby’s movement. Hehe..allowed cheating.
  9. Feel if the head is engaged – blobbing. Face the feet while doing this.
  10. Listen for the fetal heart beat using the Pinard stethoscope to assess the rate and rhythm . At the same time, feel maternal pulse to make sure it’s really the baby’s heart I’m listening. If I cannot hear using the pInard, I will request for the SonicAid.
  11. After that, thank the patient and help her to dress and then sit up. I will check for signs of anaemia on her hands and face. Then, I will present my findings to the examiner.
  12. Finally, say that I’ll check the BP and urine.

I hope I didn’t forget anything. Silalah tambah mana yg berpatutan.

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Comments»

1. Puteri Nad :-) - April 15, 2007

terus kasi full mark

2. little healer - April 15, 2007

time kaceh..

3. Zy - April 15, 2007

alhamdulilah..dah selamat dilahirkan.. maybe berkat budak2 4th year gi buat examination kat perut si ibu..maka si bayi tidak sabar untuk melihat dunia..Sumayyah Mujahid nama diberi.. comel~~~ all the best for your OSCE exam. cia yo!


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