Undergraduate course lectures in obstetrics and Gynecology Prepared by Dr Manal Behery Professor of OB&Gyne Faculty of medicine ,Zagazig University

1. DR: Manal Behery
Zagazig University,Egypt
2014
DR: Manal Behery
Zagazig University,Egypt
2014
OSCE Obstetrics EXAM

2. A B
slide1

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

4. Left occipto anterior

5. DOA DOP(face To Pubis)

6. Slide 2

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

9. Slide3

10. • What is the cord anomaly shown In this
photo?
• What is the possible complications of this
condition ?How to diagnose this complication
Slide3

11. slide4

12. 1- What does this graph show?
2- describe the type of abnormal couse you see
3- how would you manage this condition
.
slide4

13. History Of Partogram
• Friedman's partogram
•

14. A prolonged latent phase
B prolonged active phase
C arrest active phase
Abnormal progress in labor

15. Philpott alert and action line

16. 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

17. 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

18. Normal labor progress
• At addmision
• Then after 4h

19. Abnormal labor progress

20. Obstructed labour
Assessment:
Powers
Passenger
Passages

21. Slide 5

22. • What is the name of this maneuver ?What is
the indications?
• What is the prerequisite ?
• What is the complication ?
Slide5

23. Slide 6

24. • 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

26. Rubin maneuver vs. bring post arm

27. • determine
slide 7

28. • determine position in this photo?
• What is the attiude of this fetus?
• What is the mechnism by which head is delivered?
slide7

29. slide8

30. 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

31. Variable Deceleration

33. Slide 9

34. • what is the name of this instrument
• what does it detect
• what is the character of normal CTG trace
Slide 9

35. Toco = uterine activity
Fetal
heart
rate

36. Baseline rate
Contractions
Irregular 1-2:10
Variability = 20 bpm
accelerations
No decelerations

37. Baseline rate = 170-180
Variability = 5
No accelerations Contractions 4:10
Late
decelerations

38. Slide 10

39. 1. What this image show?
2. What is the possible cause cause ?
3. What is the defferntial diagnosis?
Slide 9

40. • ?
Slide11

41. • What does this image show?
• What is the cause of this problem ?
• How to manage?
Slide 11

42. Slide12

43. • 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

44. 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

45. Slide 13

46. • What is the name of this maneuver?
• What is the indication ?
• What is the prerequisite?
• Name 2 complication
Slide 13

47. 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

48. slide14

49. • What this image show?
• What is the main cause of this abnormaility?
• What is the complications?name 2
Slide 14

50. Slide 15

51. • What does this image show?
• What is the complication of this method?
• Name 2 other possible alternative methods
Slide 15

52. Slide16

53. • 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

54. Slide17
A
B

55. • What this photo show?
• What is the risk factor?
• What is the degree in A &B?what is the main
complication ?
A
B
Slide17

56. Answer

57. Slide18

58. • 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

59. slide19

60. • What does this picture show
• What is the indication ?
• What is the prerequisite?
Slide 19

61. • ?
Slide20

62. • What is the name of these 2 traingle?
• How to define outlet contraction?
• What is Thomas” dictum ?
Slide20

63. An outlet with male pelvic character

64. Contracted vs. capacious outlet

65. Slide 21

66. • What is this maneuver ?
• Why it is performed ?
• How it is performed ?
• What is the risk of sudden extension of fetal
head?
Slide 21

68. Slide 22

69. • What is cause of this emergency situation
• Give 2 diagnostic signs
• Give 4 factors affecting prognosis of this
condition?
Slide 22

70. Diagnosis
Cord pulsations
CTG shows
variable decelerations
 Fundal pressure
causes bradycardia
Meconium stained
liquor

71. Slide 23

72. • What this image show ?
• What is the cause ?
How to diagnose this case antenatally?
Slide 23

73. • What is the name of this maneuver ?
• What is the indications
• Name 2 complications
Slide 24

74. • What is the name of this maneuver ?
• What is the indications
• Name 2 complications
Slide 24

75. Slide 25

76. 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

77. Slide26

78. 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

80. Dichoronic vs. monochoronic

82. Slide 27

83. 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

84. Slide 28

85. • What is the placental anomaly shown In this
photo?
• What is the possible complications of this
condition ?How to diagnose it antenatally?
Slide28

86. Placenta succenteuriata:
Complication
1. Retained placenta
2. Postpartum hemorrhage
3. peurpral sepsis
Diagnosis
1. US and Doppler

87. Slide29

88. • What is the placental anomaly shown In this
photo?
• What is the possible complications of this
condition ?How to diagnose it antenatally?
Slide29

89. 1. Bipartite placenta
Complication
1. Retained placenta
2. Postpartum hemorrhage
3. peurpral sepsis
Diagnosis
1. US and Doppler

90. by Doppler :Bilobate placenta

91. Slide30

92. a)What this image show?
b)What it this process called?
c)How you detect it by PV ?
Slide30

94. Slide31

95. 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

96. 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),

97. Slide 32

98. Slide 32
1)What is the name of this
maneuver ?
2)What is the complication
?name 2
3)Name 2 other maneuver ?

99. Slide 33

100. • 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

101. a/r