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

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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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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