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DR: Manal Behery
Zagazig University,Egypt
2014
DR: Manal Behery
Zagazig University,Egypt
2014
OSCE Obstetrics EXAM
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A B
slide1
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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
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4.
Left occipto anterior
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DOA DOP(face To Pubis)
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Slide 2
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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
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8.
Slide3
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9.
• What is the cord anomaly shown In this
photo?
• What is the possible complications of this
condition ?How to diagnose this complication
Slide3
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10.
slide4
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11.
1- What does this graph show?
2- describe the type of abnormal couse you see
3- how would you manage this condition
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slide4
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History Of Partogram
• Friedman's partogram
•
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A prolonged latent phase
B prolonged active phase
C arrest active phase
Abnormal progress in labor
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Philpott alert and action line
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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
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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
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Normal labor progress
• At addmision
• Then after 4h
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Abnormal labor progress
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Obstructed labour
Assessment:
Powers
Passenger
Passages
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20.
Slide 5
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21.
• What is the name of this maneuver ?What is
the indications?
• What is the prerequisite ?
• What is the complication ?
Slide5
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Slide 6
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• 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
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Rubin maneuver vs. bring post arm
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25.
• determine
slide 7
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26.
• determine position in this photo?
• What is the attiude of this fetus?
• What is the mechnism by which head is delivered?
slide7
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27.
slide8
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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
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Variable Deceleration
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30.
Slide 9
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• what is the name of this instrument
• what does it detect
• what is the character of normal CTG trace
Slide 9
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Toco = uterine activity
Fetal
heart
rate
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Baseline rate
Contractions
Irregular 1-2:10
Variability = 20 bpm
accelerations
No decelerations
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Baseline rate = 170-180
Variability = 5
No accelerations Contractions 4:10
Late
decelerations
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Slide 10
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1. What this image show?
2. What is the possible cause cause ?
3. What is the defferntial diagnosis?
Slide 9
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• ?
Slide11
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• What does this image show?
• What is the cause of this problem ?
• How to manage?
Slide 11
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Slide12
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• 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
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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
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Slide 13
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• What is the name of this maneuver?
• What is the indication ?
• What is the prerequisite?
• Name 2 complication
Slide 13
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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
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slide14
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• What this image show?
• What is the main cause of this abnormaility?
• What is the complications?name 2
Slide 14
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Slide 15
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• What does this image show?
• What is the complication of this method?
• Name 2 other possible alternative methods
Slide 15
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Slide16
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• 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
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51.
Slide17
A
B
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• What this photo show?
• What is the risk factor?
• What is the degree in A &B?what is the main
complication ?
A
B
Slide17
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Answer
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Slide18
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• 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
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slide19
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• What does this picture show
• What is the indication ?
• What is the prerequisite?
Slide 19
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• ?
Slide20
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• What is the name of these 2 traingle?
• How to define outlet contraction?
• What is Thomas” dictum ?
Slide20
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An outlet with male pelvic character
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Contracted vs. capacious outlet
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Slide 21
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• What is this maneuver ?
• Why it is performed ?
• How it is performed ?
• What is the risk of sudden extension of fetal
head?
Slide 21
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Slide 22
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• What is cause of this emergency situation
• Give 2 diagnostic signs
• Give 4 factors affecting prognosis of this
condition?
Slide 22
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Diagnosis
Cord pulsations
CTG shows
variable decelerations
Fundal pressure
causes bradycardia
Meconium stained
liquor
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Slide 23
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• What this image show ?
• What is the cause ?
How to diagnose this case antenatally?
Slide 23
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• What is the name of this maneuver ?
• What is the indications
• Name 2 complications
Slide 24
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• What is the name of this maneuver ?
• What is the indications
• Name 2 complications
Slide 24
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Slide 25
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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
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Slide26
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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
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Dichoronic vs. monochoronic
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Slide 27
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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
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Slide 28
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• What is the placental anomaly shown In this
photo?
• What is the possible complications of this
condition ?How to diagnose it antenatally?
Slide28
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Placenta succenteuriata:
Complication
1. Retained placenta
2. Postpartum hemorrhage
3. peurpral sepsis
Diagnosis
1. US and Doppler
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Slide29
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• What is the placental anomaly shown In this
photo?
• What is the possible complications of this
condition ?How to diagnose it antenatally?
Slide29
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1. Bipartite placenta
Complication
1. Retained placenta
2. Postpartum hemorrhage
3. peurpral sepsis
Diagnosis
1. US and Doppler
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by Doppler :Bilobate placenta
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Slide30
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a)What this image show?
b)What it this process called?
c)How you detect it by PV ?
Slide30
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Slide31
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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
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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),
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Slide 32
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Slide 32
1)What is the name of this
maneuver ?
2)What is the complication
?name 2
3)Name 2 other maneuver ?
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Slide 33
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• 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
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a/r
Amniotic hook/amniotic membrane perforater
Amniotomy (artificial rupture of membrane)
Fetal: Cord prolapse, intrauterine fetal infection, conversion of unstable lie to tranverse obstructed lie with prolapse of arm.
Maternal: Trauma to genital tract n LS of uterus, maternal infection, abruptio placenta (if sudden rupture in polyhydramnion),
Amniotic hook/amniotic membrane perforater
Amniotomy (artificial rupture of membrane)
Fetal: Cord prolapse, intrauterine fetal infection, conversion of unstable lie to tranverse obstructed lie with prolapse of arm.
Maternal: Trauma to genital tract n LS of uterus, maternal infection, abruptio placenta (if sudden rupture in polyhydramnion),
Amniotic hook/amniotic membrane perforater
Amniotomy (artificial rupture of membrane)
Fetal: Cord prolapse, intrauterine fetal infection, conversion of unstable lie to tranverse obstructed lie with prolapse of arm.
Maternal: Trauma to genital tract n LS of uterus, maternal infection, abruptio placenta (if sudden rupture in polyhydramnion),
Amniotic hook/amniotic membrane perforater
Amniotomy (artificial rupture of membrane)
Fetal: Cord prolapse, intrauterine fetal infection, conversion of unstable lie to tranverse obstructed lie with prolapse of arm.
Maternal: Trauma to genital tract n LS of uterus, maternal infection, abruptio placenta (if sudden rupture in polyhydramnion),