‫ حسام البدراوي‬.‫د‬.

‫وحدة أ‬
Obstetric cases

(1)
17 ,‫ مها عاطف عبد السالم‬years old, primigravida, unsure of dates, 29 w by U/S,
coming for ANC

Examination:
-Head: Scar at left aspect of forehead, 1 cm, 2ry intention
-Mouth: Dental caries

-Upper limbs: .Multiple scratch marks on Lt UL

. Burn scar 5 x 4cm, on dorsum of Lt hand

-Chest: .Scar on rt sternal border, 3cm, 2ry intention

.Burn scar on lt sternal border, 2 x 1 cm

-Breast: Hyperpigmented areola

-Abdominal:

Fundal level: 28w

Fundal grip: buttocks

Umblical grip: back anterior & to the right

1st pelvic grip: head

(2)
26 ,‫ جيهان محمد أحمد سليمان‬years old, primigravida, preg. ±28w, cardiac (AVR,
mitral & tricuspid valves repair)

Examination:
-Upper limbs:

.Multiple scratch marks on Lt UL

.Burn scar 3cm, 1ry intention on dorsum of Lt forearm

.Swelling 1 cm below the elbow.

-Chest: Scar of median sternotomy, 15cm, fish bone appearance, complicated

by keloid formation

-Breast: Hyperpigmented areola & Montegomory tubercles

-Heart: 2nd heart sound replaced by click sound

-Abdominal:

Fundal level: 33w

Fundal grip: buttocks

Umblical grip: back anterior & to the right

1st pelvic grip: head

 Gynecological cases
(1)
55 , ‫ نوال حافظ ابراهيم‬y old G5 P5 é 4 living with 4 offsprings (1 male & 3
females), postmenopausal bleeding of 3 months duration, HCV +ve
Examination:
-Head: .Multiple insect bites

.Eyes: Arcus senilis, Pterygium

-Mouth: Teeth: ..lost lower left 1st molar tooth

..4 artificial dentures (the 4 upper incisors)

-Upper limbs: Multiple ecchymotic patches on the arms & forearms forearms of
both ULs

-Lower limbs:

.Multiple scattered varicosities on both thighs.

.Burn scar on the lateral aspect of the upper left thigh about 4cm

.Cellulitis on the anterolateral aspect of lower left leg

-Abdominal:

.Inspection: Generalized abdominal distension

.Palpation: Deep palpation:

Liver: Rt lobe felt 8 cm below Rt MCL

Lt lobe felt 8 cm below midline

Firm in consistency, smooth surface, sharp edge, not tender

Spleen: Felt 10 cm from left costal margin, firm in consistency, smooth

surface, sharp edge, not tender

-Local:

Inspection: Mild cystorectocele

Speculum examination: Cervix shows multiple Nabothian follicles

(2)
26 ,‫ نادية عبد المحسن محمد‬years old, G2 P1 é 1 living offspring, 2ry infertility for
7years, previous 2 CS.

Examination:
-Neck: Scar below the Lt angle of the mandible, 2ry intention
-Lower limbs: Hypopigmented area 3x2 cm below medial malleolus of the lt LL
-Abdominal: .Multiple striae alba on both flanks.

.Scar of Pfannensteil incision, 10 cm, 1ry intension

(3)
43 ,‫ عزة عبد الحميد أحمد‬years old, 1ry infertility for 4.5 years

Examination:

-Head: Multiple nevi in the face

-Neck: 2 skin tags on the left aspect

-Upper limbs: .Multiple small burn scars on dorsum of left forearm

.Flexion defprmity in little & ring fingers

.Scar 2cm on dorsum of proximal phalynx of ring finger

-Lower limbs:

.Multiple small scattered varicosities on both thighs & legs

.Scar on dorsum of rt foot, 5 cm, 1ry intention.

-Abdominal: Scar of Pfannensteil incision, 10 cm, 1ry intention

(4)
49 ,‫ مديحة عبد الواحد قرني‬years old, G7 P6+1 é 6 living offsprings (4 males & 2
females), cystorectocele

Examination:

-Mouth: Dental caries

-Neck: Scratch marks below the mandible
-Upper limbs: Multiple burn scars the largest 1.5 cm at dorsum of rt forearm
-Lower limbs: .Multiple small scattered varicosities on both thighs

.Prominent lateral malleoli

.Multiple scars on both buttocks the largest 2 cm

.Scar on the shin of left tibia: 3 cm, 2ry intention

-Breast: The rt breast shows upper circumareolar incision 7 cm, 1ry intention

-Local:

Inspection: Deficient perineum 2cm

Cystocele

Rectocele

Speculum: Chronic non specific cervicitis

(5)

39 ,‫ ليلى جمعة أبو العيد‬years old, G4 P4 é 4 living offsprings (2 males & 2 females),
cystorectocele, 2nd degree uterine prolapse, HCV +ve

Examination:
-Mouth: .Lost 1st right lower molar tooth

.Lost 1st & 2nd left lower molar teeth

-Neck: Scar of Kocher incision, 10 cm, 2ry intension

-Upper limbs: Burn scar on the middle third of ant aspect of rt forearm 1.5 cm

-Lower limbs:
.Multiple striae alba on upper aspect of front of both thighs

.Burn scar on middle of lateral aspect of rt thigh, 2 cm

.Scar on ant aspect of middle of lt knee, 3cm, 2ry intension

.Multiple scars of previous traumas on both legs

-Local:
Inspection: Deficient perineum

Moderate cystocele, rectocele, 2nd degree uterine prolapse

No stress incontinence

Speculum: Chronic non specific cervicitis