Unit 2 Ward Test Obs&Gyne Guide

By Sadaf Hafeez (class of 2013)

The test is conducted on your last day in unit 2.Its conducted by PGs.Passing percentage is 60%.One can appear again with next batch in case you flunk it on first attempt.There are three stations.

First station has viva from any topic taught to your batch in unit 2.Ma'am goes into details of one topic like if she asks about Twin Pregnancy,she starts from its definition to its types,risk factors, complications etc You can't get away with superficial study on this station :(

Second Station is of Instrument:
You're asked to identify and tell the use of some instrument.
Some similar-looking instruments:

Vulsellum ( its tip is bend)
Used in non pregnent uterus to hold ant and post lips of cervix

Allis Tissue Forceps ( Its tip is straight)
Used to hold Rectus Sheath

Green Armitage Clamp
( Applied on Utreus to control bleeding )

You can revise the rest of the instrument on these links

Instruments and Uses By Rabia Jameel (class of 2013)

Instruments By Rayhan Ahmad (class of 2012)

 

Third Station Is Of Dummy:
Ma'am puts the fetus in an abnormal position or lie and asks you to identify it, tell its causes, management .For that read Chapter 30 and 31 of Obs-textbook by dr Arshad Chohan.

Video on Breech Delivery with Maneuvers (Its a youtube video.You need to activate Spot-flux to view it)

Ready-Made Summaries Of Imp. Questions in TOCS by Dr.Nadeem Goraya

Summary1. INDICATIONS OF OUTLET FORCEPS

Always keep this tip with you & read it daily..

1-Prolonged 2nd stage of labor

2- Maternal exhaustion

3- mother not able to push

4- When pushing is not required

5- Fetal distress .

6- High head at doing C section

7- After coming head of breech.

Obstructed labor is not an indication rather it is a contraindication.

PRE REQUISITES for APLICATION OF OUTLET FORCEPS (MNEMONIC: FORCEPS)

F - FULLY DILATED CERVIX.

O - Outlet adequate no CPD.

R - Ruptured membranes .

C - Contractions present.

E - Engagement of head and episiotomy.

P - Presentation: Cephalic. Position: occipito anterior

S - Surrounding structures empty: Rectum & bladder.

COMPLICATIONS OF FORCEPS.

Fetal facial nerve palsy

Intra cranial hemorrhage

Maternal injury to surrounding tissue and perineal tears.

Summary 2. D&C

It is one of the most commonly performed gynecological procedure which every student will be asked about. So you must know indications, procedure, instruments and complications of it.

INDICATIONS:-

1.Irregular vaginal bleeding after the age of 40years

2.Irregular vaginal bleeding before the 40years of age if medical management failed

3.Post menopausal bleeding

4.For the diagnosis of endometrial tuberculosis

5.Some procedures in which uterus retained like Manchester repair.

D&C is not always performed under GA it can also be performed in para-cervical block.

COMPLICATIONS of D&C:-

Immediate: Anesthesia complications, Hemorrhage, perforation, injury to surrounding tissues.

Late: Infection

Delayed: Asherman 's syndrome.

Summary 3.
A+B=C (Breech Delivery)

Dont be afraid this is not a mathematical Q

Any obstetrical complication(A) associated with BREECH(B) mode of delivery is C/s(c).

COMPLICATIONS

1.Hypertension

2. Diabeties mellitus

3. Previous one c/s

4.p previa any type

5. IUGR

6.Rh incompatability

7.twins with ist fetus breech

8. Footling breech

9.wt of the fetus >3.75kg <2.5 kg

10. Poly or oligohydramnios

11.exteded attitute of fetal head. elective C/S for breech should be performed at 38weeks.

FEW MANOUVERS IN BRREECH DELIVERY.

PINARD MANOUVER for exteded legsLOVSET MANOUVER for exteded arms.

MARACEUIA SMELI VIET MANOUVER.

BURN'S MARSHAL TECNHNIQ&

PIPERS FORCEPS For aftercoming head.

Maternal complications of breech delivery

1.Increased ç/s

2tears

3.infections.

fetal.

1fracture of femur and dislocation of hip joint

2. Injury soft tissuesLIVER

3humers fracture

4clavicle fracture

5sublaxation of atlantoaxial joint

6intracranial haemorage

7hypoxia.read

Click here for more summaries by Sir Nadeem Goaraya