VAGINAL EXAMINATION DURING LABOUR

REQUIREMENTS #

1. Sterile vaginal exam pack containing the following:
   1. Gallipot
   2. Two Receivers
   3. Amniotic forceps or hook
   4. Sponge holding forceps
   5. Swabs
   6. Disposable Towels
   7. Antiseptic Solution e.g. savlon
   8. Antiseptic vaginal cream or sterile lubricant e.g. Hibitane cream
   9. A pair of sterile gloves
   10. Perineal pad
   11. Mackintosh apron
   12. Mackintosh
   13. Draw sheet
   14. Drape

STEPS #

1. Explain the procedure to the client (Refer steps)
2. Help client to empty bladder and provides privacy
3. Protect bed with mackintosh and assist client to lie on her side
4. Perform hand hygiene and wear protective clothing
5. Instruct client to assume the dorsal position with legs flexed and knees apart
6. Drape client and asks client to expose vulva
7. Inspect vulva and swabs with strokes from upwards downwards starting with the labia majora
8. Separate the labia minora and swabs vestibule using a swab for each stroke
9. Using the right hand, the middle and index fingers are inserted gently into the vagina pressing firmly downwards
10. Speculum is use when indicated (premature rupture of membranes, premature labour)
11. Assess the cervix for degree of dilatation and moulding, rupture of membranes, liquor, presenting part, position and adequacy of the pelvis
12. Withdraw examining fingers gently and observe
13. Tidy up client, apply clean perineal pad
14. Put client back in a comfortable position and communicate findings to her
15. Appreciate client for her cooperation
16. Dispose off used items and decontaminate
17. Perform hand hygiene
18. Record and report findings to Officer in-charge