Pelvic examinations during
labor are used for several purposes, among them assessment of cervical
dilatation, effacement, station of the presenting part, presentation,
position, and pelvic capacity.
Instruction in these techniques is particularly important for those
health care providers involved in labor management, including
physicians, nurses, midwives, paramedics and EMT personnel.
The short, free video provides
an introduction to this technique. The longer, 5-minute video
demonstrates these techniques, using live patients, models and
graphics.
Pelvic Exam During Labor Runtime 0:29 Min
1.4 MB wmv
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Using sterile gloves and lubricant,
perform a vaginal exam and determine the dilatation and effacement of
the cervix. A small amount of bleeding during the days or hours
leading up to the onset of labor is common and called "bloody show."
Print a Cervical Dilatation Chart
Dilatation is expressed in centimeters.
I have relatively large fingers, and for my hands, I make the
following generalizations:
- 1.5 cm: One finger fits tightly
through the cervix and touches the fetal head.
- 2.0 cm: One finger fits loosely
inside the cervix, but I can't fit two fingers in.
- 3.0 cm: Two fingers fit tightly
inside the cervix.
- 4.0 cm: Two fingers fit loosely
inside the cervix.
- 6.0 cm: There is still 2 cm of
cervix still palpable on both sides of the cervix.
- 8.0 cm: There is only 1 cm of cervix
still palpable on both sides of the cervix.
- 9.0 cm: Not even 1 cm of cervix is
left laterally, or there is only an anterior lip of cervix.
- 10.0 cm: I can't feel any cervix
anywhere around the fetal head.
Effacement is easiest to measure in
terms of centimeters of thickness, ie., 1 cm thick, 1.5 cm thick, etc.
Alternatively, you may express the thickness in percent of an
uneffaced cervix...ie, 50%, 90%, etc. This expression presumes a good
knowledge of what an uneffaced cervix should feel like.
From OBGYN 101 |
