VAGINAL
EXAMINATION
ALBY SHIJU
INTRODUCTION
A vaginal examination is an internal physical
examination done by a doctor or midwife . In most
cases during pregnancy , this procedure helps you to
assess your cervix to help understand labour
readiness and progression . It assesses the vagina ,
cervix , uterus and other reproductive organs .
DEFINITION
The examination done per vagina to assess the
status of vagina , cervix and progress of decent of
foetus through the birth canal
INDICATIONS
• Onset of Labour
• Progress of Labour
• Following the rupture of membrane
• Diagnose the begining of 2nd stage of Labour
• Identify the presenting part of the foetus
ARTICLES
• Gloves
• Apron
• Mask
• Lubricant jelly
• Betadine solution
• Swabs
• Sponge holding forceps
PRE-PROCEDURE
• Ask the client to wear gown
• Remove the pubic hair
• Bladder should be emptied
• Provide perineal care to the client
• Provide lithotomy position
PSYCHOLOGICAL
PREPARATION
• Explain the procedure
• Take informed consent
• Advise to take deep breths during
procedure
• Relaxation of abdomen and perennial
muscles
• Ensure their privacy
PROCEDURE
• Perform hand hygiene
• Wear mask , cap and Apron
• Provide dorsal recumbent position with legs
flexed at the edge of examination table
• Observe the external genitalia for
;
1. Vericositis , warts & sores
2. Previous episiotomy & laceration
3. Discharge and bleeding
4. Show
5. Colour and odour of discharge
• Cleanse the vulva and perineal area with betadine
solution
• Drape the perineal area with sterile sheet
• Holding the labia apart by left hand , insert the right
hand gloved finger into the vagina
• Assess the vulva : bulgig , soft and stretchable
• Effacement : taking up / shortening of cervix
• Dilatation : gaping of internal os ( 0 - 10 cm )
• Forewater : present / absent
• Station of head : at level of ischeal spine
• Bag of membrane : intact / ruptured
• Foetal position : anterior / posterior lateral
• Presentation : vertex , breech , face , brow
• At completion of examination withdraw
finger from the vagina , take care to note
the presence of any blood or amniotic fluid
POST -
PROCEDURE
• Clean and dry the perennial area and
buttocks
• Give sterile perennial pad if leakage
• Remove gown and mask
• Auscultate the FHR and chart the findings
• Shift to bed and provide left lateral position
• Record and report findings
• Instructed to inform any excess bleeding
after the procedure and do follow up
COMPLICATIO
NS
• Infection of mother and foetus
• Premature rupture of
membrane
• Pain
• Misdiagnosis of labour
• Exaggeration of symptoms
CONCLUSION
A vaginal examination is a physial examination
performed by a doctor or midife to assess the
vagina and cervix .
It helps to check the size and shape of uters and
ovaries , noting any tender area or any unusual
growths . It can be performed while having
unexplained pelvic pain , irregular vaginal
bleeding , abnormal vaginal discharge and as a
part of assessment of a pelvic mass . Yet it is
mostly performed during pregnancy period
THANK YOU
FOR YOUR ATTENTION
