posterior ?

[jzprple]

Ok so I have a question. The other night a Doc was doing a SVE on my labor patient and said "she's 1-2, 70, 0 and very posterior. When they say this...what do they mean w/ the posterior comment? Like is the baby OP? or her cervix is posterior?? I feel so stupid asking this question but I can't figure it out and can't find it in my OB textbook anywhere so I thought I'd ask the smart people on here....thanks for the help!

[RNKitty]

He means the cervix is posterior, or way back by her tailbone. Hard to reach if you have short fingers like me!

[babyktchr, BSN, RN]

:yeahthat:

[SmilingBluEyes]

Trick of the trade for reaching posterior cervices (and sky-high presentations)

*First, take the time to really explain in detail what you are going to do first----that she will feel as if she is standing on her head, even-----before you do this. That way, they don't freak out when you lower them to an almost trendelenburg position to reach their cervix/presenting part of the baby.

*Try to have WARM hands to check the mom's cervix---this is pretty important to me.

*Have mom put her hands behind the small of her back, or use a bed pan underneath her bottom.

*Lower head of bed as far as it will go

*Have her put her ankles together, knees wide apart and breathe deeply to relax---do NOT nudge her legs or move them for her, let her do this in her good time-----she will more likely relax and a relaxed mom is one that is much easier to check.

*Use well-lubricated gloved hand, gently "scoop" along the posterior wall of her lady parts, til you find the cervix.

Doing these things, even if you have very short fingers, or you are working w/moms with very posterior cervices, you are just about guaranteed to "find" that posterior cervix!!!!

Good luck.

[jzprple]

THANKS ALL!!! I'm so lost when it comes to vag exams but I know I have to just keep practicing to get it down...

[Selke]

Trick of the trade for reaching posterior cervices (and sky-high presentations)

... ...

*Use well-lubricated gloved hand, gently "scoop" along the posterior wall of her lady parts, til you find the cervix.

Doing these things, even if you have very short fingers, or you are working w/moms with very posterior cervices, you are just about guaranteed to "find" that posterior cervix!!!!

Good luck.

Thanks for this techinique. I use the fists behind the buttocks, sometimes the bedpan, or McRoberts' (have her put her hands behind her thighs and pull her legs back as far as possible). But I didn't know about the "scooping" motion. Thanks!

Smilingblueeyes, do you have tips for checking position -- if you do this? I haven't paid much attention to this before now (because the exam is more painful for the pt and I really haven't had to do it; but now I want to practice before I get into clinicals). I have difficulty finding the fontanel.

Another type of exam I'm not too sure about -- the pt with I guess it's a short lady parts, the baby feels like it's right there on the perineum, it sits very low in her pelvis, and the perineum is so tight in front of the baby's head it's difficult to get my fingers around to find the posterior curve of the cervix. This doesn't happen very often and I haven't talked with anyone about how to do a better exam in this situation. Last week I had a pt like this and I was calling this a +2 or +3 type of exam, which was incorrect per the MD who checked the pt. He said she was a 0 station according to the prominences. She couldn't empty her bladder the baby was so low.

Thanks!