OBSTETRICS AND

GYNECOLOGIC
EXAMINATION
I Gede Ngurah Harry Wijaya Surya
Uro-Ginecologic and Reconstruction Division, Obstetrics and
Gynecology Department,
Faculty of Medicine, Udayana University

CLINICAL SKILL-2011

OUTLINED

How to conduct
obstetrics
examination?
How to conduct
gynecologic
examination?

GENERAL CONSIDERATION

SPECIAL PATIENTS ~
WOMEN
EMPATY
GENTLE
INITIAL ASSESMENT :
Anamnesis
Physical
examination
Additional
examination

OBSTETRICS
EXAMINATION

OBSTETRICS EXAMINATION

ANAMNESIS :
Obtain patient identity
Present illnes (sacred seven)
Patients diseases history
Familys diseases history
Social history
PHYSICAL EXAMINATION :
General examination
Inspection, palpation, Auscultation,
Vaginal
taucher (specific examination)
Preparation : patient, equipment,
examiner
ADDITIONAL EXAMINATION

ANAMNESIS

Menstrual cycle history :

Last menstruation periode (LMP)
Estimated date of delivery (EDD)
Obstetrics history :
Number of pregnancy, amount &
sex of the
child, mode of delivery, birth
weight
Current pregnancy history

1st & 2nd TRIMESTER

General examination
Focus on lower abdomen & genitalia
Palpation
Auscultation

1st & 2nd TRIMESTER

SPECIFIC EXAMINATION : VAGINAL TOUCHER (VT)

Empty bladder
Lithotomy position
Gloves
Vulva hygiene
Inspeculo :
VT :
Vulva
Uterus
Vagina
Adnexa/parametrium
(AP)
Portio
Douglas cavity (CD)

3rd TRIMESTER

General examination
Focus on LEOPOLD MANEUVERS :
1st Maneuver
2nd Maneuver
3rd Maneuver
4th Maneuver
Patient position
Examiner position

1st MANEUVER

2nd MANEUVER

3rd MANEUVER

4th MANEUVER

3rd TRIMESTER
VAGINAL TOUCHER (VT)

Lithotomy position
Gloves
Vulva hygiene
Identified :
Effacement & dilatation of cervix
Amniotic membrane (intact/rupture)
Lowest part of baby & descencus
Tumor of birth canal?

ADDITIONAL EXAMINATION
ROUTIN BLOOD
EXAMINATION
ROUTIN URINE
EXAMINATION
ULTRASONOGRAFI

CASE
A women, 30 years old, with last
menstuation periode March 17th 2011,
came to obstetrics emergency room due
to she felt regularly abdominal cramp
and slight vaginaly bloody show.
How do you conduct anamnesis,
phyical
examination, and additional
examination
needed to obtain
the diagnosis?

GYNECOLOGIC
EXAMINATION

GYNECOLOGIC
EXAMINATION

ANAMNESIS :
Obtain patient identity
Present illnes (secred seven)
Patients diseases history
Familys diseases history
Social history
PHYSICAL EXAMINATION :
General examination
Inspection, palpation, Auscultation,
Vaginal
taucher (specific examination)
Preparation : patient, equipment,
examiner
ADDITIONAL EXAMINATION

ANAMNESIS

MAIN COMPLAINS :
Vaginal bleeding
Vaginal discharge (leucorrhea)
Pain
Swelling
Vaginal bleeding :
Related to menstruation?
(menorhagia,
metrorhagia,
poli/oligomenorhea)
Amenorhea history?
Post coital bleeding?
During menopause?

ANAMNESIS

Vaginal discharge (leucorrhea) :

Fisiologis?
Patologis?
Type of leucorrhea suggestion to
etiology
Pain :
Dismenorhea?
Dispareunia?
Pain of the lower abdomen?

ANAMNESIS

Menstrual cycle
history
Obstetrics history
Gynecologic
history

PHYSICAL EXAMINATION

ADDITIONAL EXAMINATION
ROUTIN BLOOD
EXAMINATION
ROUTIN URINE
EXAMINATION
-hCG SERUM/URINE
VAGINAL SWAB
ULTRASONOGRAFI
CT-SCAN
MRI

CASE
A women, 37 years old, paritas 2, came
to gynecological out patient clinic due to
having excessive vaginal bleeding
during menstruation periode.
How do you conduct anamnesis,
phyical
examination, and
additional examination
needed
to obtain the diagnosis?