OSPITAL NG MAYNILA MEDICAL CENTER

Obstetrics and Gynecology Department

Residency Training Program

OSCE (History taking/Pelvic exam/Leopold’s Maneuver/Clinical Pelvimetry)

OB History Taking OSCE

Name of Resident: Date:

Year level: Examiner:
SCORE:

Case Scenario 1: Patient came in for prenatal check up. She is 28 year old G2P1.
LMP: February 25, 2022. (+) Urine pregnancy test. Height: 150 cm Weight: 70kg

Task: Perform OB history and PE (Pelvic exam + Papsmear)

Side question: What is the BMI of the patient? What is the ideal increase in weight
during pregnancy?

0 Not asked 1 Asked but with prompting

2 Asked but incomplete/not in proper sequence 3 Asked, complete, and in proper sequence

0 1 2 3
Greets patient & introduces self
1ST PRENATAL VISIT (1st trimester)
Confirmation of the general data (Name, age)
Last menstrual period, previous menstrual period
HPI, symptoms (nausea, vomiting, bleeding, hypogastric pain)
OB Score & History of previous pregnancies (if applicable)
(Year, manner of delivery, AOG, Gender, BW, Place of delivery,
Assisted by, complications)
Past medical history & Family history
Personal/Social history
Review of Systems
Illnesses incurred during the trimester, meds taken
Labs/Diagnostics to request: CBC, blood typing, FBS, RPR/
VDRL, HBsAg, Anti-HBs, HIV, Rubella titer, Urinalysis/Urine
culture, pap smear, TVS
Instructions: Prenatal vitamins, follow-up every 4 weeks

2nd trimester
Symptoms (nausea, vomiting, bleeding, contractions,
fluttering/quickening)
Illnesses incurred during the trimester, meds taken
Labs/Diagnostics: PUS (fetal anatomy, growth, gender), 75g
OGTT (24-28 weeks aog)
Instructions: prenatal vitamins, follow-up every 4 weeks

3rd trimester
Symptoms (bleeding, watery discharge, contractions, fetal
movement)
Illnesses incurred during the trimester, meds taken
Labs/diagnostics: 75g OGTT (if not yet done), GBS swab (35-37
weeks), BPS & NST (37 weeks onwards), repeat CBC &
urinalysis (32 weeks onwards)
Instructions: Prenatal vitamins, follow-up every 2 weeks until 37
weeks AOG then weekly
Vaccinations: Ttox or TDaP, Hepa B @ 28 weeks onwards
Total Score /60

REMARKS:

OSPITAL NG MAYNILA MEDICAL CENTER

 Obstetrics and Gynecology Department
Residency Training Program

OSCE (History taking/Pelvic exam/Leopold’s Maneuver/Clinical Pelvimetry)

Pelvic Exam OSCE

Name of Resident: Date:

Year level: Examiner:
SCORE:

1 With knowledge but unable to perform 2 Able to perform at basic level (needs
significant help/assistance)
3 Able to perform with minimal assistance 4 Able to perform correctly &
independently

PELVIC EXAMINATION 1 2 3 4
A. Inspection & Palpation 8 points
 Describes the surface anatomy of the perineum (skin and hair
of mons and labia majora; skin of the perineum; size and
shape of the clitoris; hymen, perineal body; perineal area)
 Palpate and describe the perineum (using the examining
fingers to separate the labia minora, to palpate and describe
the urethra, posterior third of the labia majora and vaginal
orifice for any evidence of prolapse)
B. Speculum Examination 20 points
 Describe the use of patient-appropriate speculum size, prior
warming of instruments or the use of lubricant to ensure
comfort from the procedure
 Demonstrate proper placement of the speculum (placing the
transverse diameter of the blade in the AP position into the
introitus in downward motion/or aided by placing 1 or 2 fingers
into the introitus and pressing down and then turning to the
transverse axis of the vagina, with full length of the blade
inserted and gently opened and locked)
 Describe the vaginal wall (color, inflammation, discharge,
ulcers, masses)
 Describe the cervix (color, position, surface, discharge, size
and shape)
 Perform Papanicolaou Smear (samples should be taken in the
transformation zone)
C. Bimanual Examination 20 points
 Demonstrate correct bimanual examination (index and middle
finger placed deep within the vagina with thumb folded under
while the opposite hand is placed below the infraumbilical area
moving down towards symphysis pubis)
  Palpate and describe the vagina (nodularity, tenderness)
 Palpate and describe the cervix (position, shape, consistency,
mobility, tenderness)
 Palpate and describe the uterus (position, size, shape and
contour, mobility, tenderness, masses)
 Palpate and describe the adnexae (location, size, shape,
consistency and mobility of noted mass; tenderness)
D. Rectovaginal Examination 2 points
 Describe the sphincter tone, rectal walls and rectovaginal
septum (note for mass,, polyps, nodules and tenderness)
Total Score /50

REMARKS:

OSPITAL NG MAYNILA MEDICAL CENTER

Obstetrics and Gynecology Department
 Residency Training Program

OSCE (History taking/Pelvic exam/Leopold’s Maneuver/Clinical Pelvimetry)

OB Physical Exam(Fundic height, Leopold’s Maneuver, FHT) OSCE

Name of Resident: Date:

Year level: Examiner:
SCORE:

Case: Patient came for follow up prenatal check-up. She is now on her 39 weeks age of
gestation

1 With knowledge but unable to perform 2 Able to perform at basic level (needs
significant help/assistance)
3 Able to perform with minimal assistance 4 Able to perform correctly &
independently

1 2 3 4
PATIENT PREPARATION
1. Greets patient and introduces self
2. Explains the examination to patient
3. Asks patient to empty her bladder
4. Asks patient to lie supine with knees flexed to relax abdomen
5. Places a pillow under the patient’s head & Drapes properly to
maintain privacy
FUNDIC HEIGHT
6. Stands beside the patient facing her abdomen
7. Fundic height measured from the symphysis pubis to the maximum
height of the uterus/fundus using centimeters as unit of measurement
LEOPOLD 1 MANEUVER
8. Stands beside the patient facing her head
9. Gently palpates area of the uterine fundus using palms of both
hands for palpation and not the fingertips
10. Palpates gently but with firm motions
11. Feels for fetal part occupying the uterine fundus: breech (large
nodular mass) or head (hard, round, more mobile and ballotable)
12. Reports the findings
LEOPOLD 2 MANEUVER
13. Stands beside the patient facing her head
14. Places the palmar surface of both hands on either side of the
abdomen
15. Uses one hand to steady the uterus while other hand moves in
slightly circular motion from top to lower part of uterus to feel for fetal
parts; does the same to other side
16. Palpates gently but with firm motions
17. Feels for fetal part occupying both sides of the uterus: fetal back
(smooth, hard, resistant) or small parts (numerous, small, irregular,
mobile)
LEOPOLD 3 MANEUVER
18. Stands beside the patient facing her head
19. Gently grasps the lower portion of the maternal abdomen just
above the symphysis pubis between the thumb and fingers of one
hand
20. Presses slightly and makes gentle movements from side to side
21. Feels for fetal part occupying the lower uterine segment whether it
is engaged or not: breech (large nodular mass) or head (hard, round,
more mobile and ballotable)
22. Reports the findings
LEOPOLD 4 MANEUVER
23. Stands beside the patient facing her feet
24. Places tips of first three fingers on both sides of the lower abdomen
along the axis of the pelvic inlet
25. Exerts pressure downward while sliding fingers in the direction of
the birth canal
26. Determines the fetal attitude: flexed or extended head
27. Reports the findings
DETERMINATION OF FETAL HEART TONES
28. Places stethoscope over the side where the fetal back was
palpated, and listens for 1 min.
CONCLUSION
29. Explains the findings to the patient
30. Assists and thanks patient
Total /120
Score

REMARKS:

OSPITAL NG MAYNILA MEDICAL CENTER

 Obstetrics and Gynecology Department
Residency Training Program

OSCE (History taking/Pelvic exam/Leopold’s Maneuver/Clinical Pelvimetry)

Clinical Pelvimetry OSCE

Name of Resident: Date:

Year level: Examiner:
SCORE:

Case: Patient now on her 40 weeks AOG present in the OB-ER with complaints of
labor pains.

1 With knowledge but unable to perform 2 Able to perform at basic level (needs significant
help/assistance)
3 Able to perform with minimal assistance 4 Able to perform independently
1 2 3 4
PATIENT PREPARATION
1. Greets patient
2. Introduces self
3. Explains the examination to patient
4. Asks patient to empty her bladder
5. Asks patient to lie in the dorsal lithotomy position
6. Places a pillow under the patient’s head
7. Drapes properly to maintain privacy
8. Wears gloves on examining hand
9. Applies lubricant on gloved hand
10. Reports measurement of examining fingers and fist
PELVIC INLET
11. Measures the Diagonal Conjugate properly from lower border of
the symphysis pubis to the sacral promontory using tip of 2nd finger
and the point where the base of the index finger meets the pubis
12. Determines the Obstetric Conjugate by subtracting 1.5 - 2.0
centimeters depending on the inclination of the pubis
13. Reports the findings
PELVIC MIDPLANE
14. Palpates the anterior surface of the sacrum
15. Determines the splay of the pelvic sidewalls
16. Palpates the ischial spines to determine their prominence
17. Determines the bispinous diameter
18. Determines the width of the sacrosiatic notch
19. Reports the findings
PELVIC OUTLET
20. Determines the mobility of the coccyx
21. Determines the distance between the ischial tuberosities using
the fist
22. Determines the infrapubic angle using the thumb and the index
finger
23. Reports the findings
CONCLUSION
24. Explains the findings to the patient
25. Assists & thanks patient
Total Score /100

REMARKS:

OSPITAL NG MAYNILA MEDICAL CENTER

 Obstetrics and Gynecology Department
Residency Training Program

NSD, EINC & AMSTL DRILL OSCE

Name of Resident: Date:

Year level: Examiner:
SCORE:

Case: Patient is a G2P1 (1001) PU 39 weeks AOG came in due to labor pains. Internal
examination revealed 8 cm, fully effaced, negative bag of water, station +1. What will be
your next step?

1 With knowledge but unable to perform 2 Able to perform at basic level (needs significant
help/assistance)
3 Able to perform with minimal assistance 4 Able to perform independently

1 2 3 4
 Continuous maternal support by a companion of her choice
during labor and delivery
 Mobility during labor-mother is allowed to be mobile within
reason
 Monitoring the progress of labor using partograph
 Allow mother to assume position of choice during labor and
delivery
 Give non-drug pain relief before offering labor anesthesia if
needed
 Allow spontaneous pushing in semi-upright position
 Once ready to deliver, patient will be placed in dorsal lithotomy
position
 Asepsis and antisepsis, empty the bladder, place sterile
drapes
 Mother allowed to push during contractions. Upon head
crowning, do episiotomy IF NECESSARY
o Fingers insinuated between the perineum and fetal
head, cutting a median/mediolateral episiotomy
 Modified RITGEN Maneuver applied to allow controlled
delivery of the head
 Gentle downward traction to deliver the anterior shoulder then
upward traction to deliver the posterior shoulder proceeding to
delivery of the rest of the body.
 Place baby on mother’s abdomen
 Once baby is delivered, Perfor EINC/Unang Yakap
 Immediate & Thorough drying
o Using a clean, dry cloth, thoroughly dry the baby,
wiping the face, eyes, head, front and back, arms &
legs. Remove wet cloth and cover baby with another
clean, dry, warm cloth. Do not wipe off vernix
caseosa if present.
o Do quick check of newborn’s breathing
 Skin-to-skin Contact
o If a baby is crying & breathing normally, avoid any
manipulation such as routine suctioning that may
cause trauma or introduce infection. Place the
newborn prone on the mother’s abdomen or chest
skin-to-skin.
o Cover newborn’s back with a blanket & head with a
bonnet. Place identification band on ankle.
 Proper cord clamping & cutting
o Clamp & cut the cord after cord pulsations have
stopped (1-3 mins)
o Put clamps around the cord at 2 cm & 5 cm from the
newborn’s abdomen
o Cut between clamps with sterile instruments
o Observe for oozing blood
o Do not milk the cord towards the newborn
o After cord clamping, ensure oxytocin 10 IU IM is
given to the mother.
 Perform remaining steps in the active management of 3 rd
stage of labor:
o Apply controlled cord traction & counter traction on
the uterus until placenta is delivered. (Brandt
Andrew’s maneuver)
o Uterine massage until firm/contracted
o Inspect the perineum, vagina & cervix for laceration,
repair if necessary
 Non-separation of baby from the mother and breastfeeding
initiation
o Observe the newborn. Only when the newborn
shows feeding cues (e.g., opening of the mouth,
tonguing, licking, rooting), make verbal suggestions
to the mother to encourage her newborn to move
towards the breast (e.g., nudging)
o Counsel on positioning and attachment/proper
latching
 Give 2 instances when you need to perform early cord
clamping (2 pts)
 o Fetal distress/poor APGAR
o Maternal cardio-pulmonary distress
o Hemorrhage
 Give atleast 2 benefits of doing skin-to-skin contact (2 pts)
o Immuno-protection, colonization from maternal skin
flora, ingestion of colostrum, overall success of
breastfeeding, protection from hyperglycemia
 What is the advantage of delayed cord clamping (1 pt)
o Increase newborn’s iron reserve
o Reduces incidence of IDA in infancy
TOTAL SCORE /65

REMARKS: