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  • DR Monda Obs Osches 1

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    Joy Kirumba
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    Mercy is 36 weeks pregnant with her second child. She previously had a cesarean section due to breech presentation. She comes asking about her delivery options. The options presented are VBAC or elective cesarean section. Five criteria are provided for being eligible for a VBAC: 1) adequate pelvis size, 2) estimated baby weight under 3.5kg, 3) ultrasound to rule out placenta previa, 4) psychological willingness for VBAC, and 5) availability of operating theaters in the delivery facility. Three monitoring interventions during a VBAC labor are also provided: consent, IV access, and electronic fetal monitoring. Finally, five potential complications of VBAC are named: failed VBAC

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    Dr Monda Obs Osches 1

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    Mercy is 36 weeks pregnant with her second child. She previously had a cesarean section due to breech presentation. She comes asking about her delivery options. The options presented are VBAC or elective cesarean section. Five criteria are provided for being eligible for a VBAC: 1) adequate pelvis size, 2) estimated baby weight under 3.5kg, 3) ultrasound to rule out placenta previa, 4) psychological willingness for VBAC, and 5) availability of operating theaters in the delivery facility. Three monitoring interventions during a VBAC labor are also provided: consent, IV access, and electronic fetal monitoring. Finally, five potential complications of VBAC are named: failed VBAC

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    3 views2 pages

    DR Monda Obs Osches 1

    Uploaded by

    Joy Kirumba
    Mercy is 36 weeks pregnant with her second child. She previously had a cesarean section due to breech presentation. She comes asking about her delivery options. The options presented are VBAC or elective cesarean section. Five criteria are provided for being eligible for a VBAC: 1) adequate pelvis size, 2) estimated baby weight under 3.5kg, 3) ultrasound to rule out placenta previa, 4) psychological willingness for VBAC, and 5) availability of operating theaters in the delivery facility. Three monitoring interventions during a VBAC labor are also provided: consent, IV access, and electronic fetal monitoring. Finally, five potential complications of VBAC are named: failed VBAC

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    OBSTETRICS OSCE

    Interactive station

    Scenario
    Mercy is Para 1+ 0 Gravida 2 at 36 weeks gestation, with one
    previous scar due to breech presentation 3 years ago. Antenatal
    period and profiles are normal.
    She comes to you for advice on her mode of delivery

    Questions

    1. What are the options of mode of del


    VBAC or elective cs

    2. State 5 criteria for VBAC

    - Pelvimetry – Pelvis adequate (1 marks)


    - Estimation of baby weight - <3.5Kg (1 marks)
    - U/S to rule out placenta previa (1 marks)
    - Psychologically she is willing she can have VBACS (1 marks)
    - Delivery in a facility where there is availability of theatre (1 marks)

    3. Name 3 monitoring interventions during labour for


    VBAC (3 marks)
    - Consent
    - iv line
    - Gp Xm
    - Electronic fetal monitoring

    4. Name 5 complications of VBAC


    - Failed VBAC
    - Ruptured uterus
    - FD/IUFD
    - APH/ PPH
    - Visceral Injury
    - Maternal death
    OBSTETRICS OSCE

    Name of student: Registration number:

    Q Question Expected answers Score Max


    Score
    1 Counsel the examiner on  Greets patient (1 marks), 20
    Mercy’s mode of delivery  Introduces self (1 marks),
     Sits squarely (1 marks),
     Open Posture (1 marks),
     Leans Forward(1 marks), Eye Contact(1 marks),
     Relax (1 marks)
     Asks for her concerns (3 marks)

     A repeat C/S is not automatic as the last indication was a non


    recurring condition (2 marks)
     She may be eligible for SVD ie VBAC if she fulfils some
    conditions
    - Pelvimetry – Pelvis adequate (1 marks)
    - Estimation of baby weight - <3.5Kg (1 marks)
    - U/S to rule out placenta previa (1 marks)
    - Psychologically she is willing she can have VBACS (1
    marks)
    - Delivery in a facility where there is availability of theatre (1
    marks)
     If monitoring reveals any abnormality, then she will undergo
    emergency C/S (2 marks)
     Delivery by emergency C/S may be necessary in case of
    another obstetric indication (1 mark)
    Total Marks 20

    Examiner
    1.____________________________ signature _______________

    2. ____________________________ signature _______________

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