another question about vaginal exams in labor

Specialties Ob/Gyn

Published

Ok. I think I'm okay at lady partsl exams when patients are under 6cm dilated. Above that, I think I'm supposed to go by how much cervix I feel, correct? I had a patient where I found her cervix and I felt there to be

Specializes in OB, HH, ADMIN, IC, ED, QI.

If there's less than 1cm of cervix, she's 9 cm. (10-1)

It's been a while since I worked L&D, but I think either way is OK - what's left or how far apart the cervix is, by feeling the head. I never stretched my fingers to see, but ran 2 fingers from one side to the other...... Speaking of stretching, don't forget to chart to where the cervix can be stretched, mostly on multips.

Of course checking during a contraction is optimal. I've known a cervix to seem 6 cm. between contractions, and stretch to 8-9 during one. When we were still carting patients down the hall to the del rm, that meant a wild ride was had by all!

Specializes in acute rehab, med surg, LTC, peds, home c.

mslema,

What program are you in? I never had to do this in NS. Are you in training for L&D or maybe going for your NP?

Specializes in Labor and Delivery.

Honey, where is your preceptor? Are there no nurses that you feel comfortable with where you work that can help with you on your exams? We can describe what the cx feels like at 9cm but what will be helpful to you is to have someone check the pt right after you and confirm your exam. Have fun on your journey!!

Specializes in Med-surgical; telemetry; STROKE.
If there's less than 1cm of cervix, she's 9 cm. (10-1)

It's been a while since I worked L&D, but I think either way is OK - what's left or how far apart the cervix is, by feeling the head. I never stretched my fingers to see, but ran 2 fingers from one side to the other...... Speaking of stretching, don't forget to chart to where the cervix can be stretched, mostly on multips.

Of course checking during a contraction is optimal. I've known a cervix to seem 6 cm. between contractions, and stretch to 8-9 during one. When we were still carting patients down the hall to the del rm, that meant a wild ride was had by all!

Lamazeteacher,

please explain about stretching. Thank you.

Specializes in Med-surgical; telemetry; STROKE.
Honey, where is your preceptor? Are there no nurses that you feel comfortable with where you work that can help with you on your exams? We can describe what the cx feels like at 9cm but what will be helpful to you is to have someone check the pt right after you and confirm your exam. Have fun on your journey!!

I am in a training program right now. And often I see myself in the situation when I have to give my best guess because the patient is uncomfortable (before epidural) and my preceptors feel that it will be inappropriate to repeat the VE to recheck my results. Therefore I am, kind of, blindfolded :)

Therefore I also appreciate your help and advice.

Specializes in Labor and Delivery.
Lamazeteacher,

please explain about stretching. Thank you.

I am interested in hearing this as well....I have been doing l and d about 18 years and havent heard of documenting where you can stretch the cx to....when you perform a v.e. you are supposed to refrain from stretching the cx to determine dilation; if shes 4 and you can stretch her to 6, she's still 4, is she not?

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