Vaginal Examination (vaginal + examination)

Distribution by Scientific Domains


Selected Abstracts


Uterine torsion diagnosed in a mare at 515 days' gestation

EQUINE VETERINARY EDUCATION, Issue 10 2010
C. López
Summary A pregnant mare with a history of prolonged gestation (,515 days) and suspected diagnosis of fetal mummification was examined. Rectal palpation revealed that the left broad ligament of the uterus was dorsal and medial to the right uterine ligament and it was not possible to observe the cervix during vaginal examination. Transabdominal ultrasound revealed fluid in the uterus, fetal membranes and the uterine walls defined and thickened. Free fluid was not seen in the peritoneal cavity. Laboratory tests (blood cell count and clinical chemistry) were normal. Based on clinical history, physical examination and ultrasound findings, a chronic uterine torsion with fetal death was diagnosed and the mare was subjected to exploratory celiotomy. The uterus was strongly adhered to the peritoneum of the ventral abdominal wall and there were multiple adhesions to the colon. Hysterotomy was performed to remove the fetus and to permit repositioning of the uterus. When the fetus was removed, a large devitalised grey tissue area of the right ventral uterine horn was observed. Multiple adhesions prevented a rescue hysterectomy and euthanasia of the patient was performed. During the necropsy, a 180° cranial cervix clockwise uterine torsion was observed. This rare case of uterine torsion appears to be the most chronic case reported in the equine literature. [source]


Urinary Bladder Herniation through a Vaginal Tear in a Rottweiller with Dystocia

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2000
DACVECC, Deborah C. Mandell VMD
Summary A four-year old female Rottweiler presented with a 34-hour history of dystocia. Physical examination revealed a purple-black, fluid-filled sac protruding from vulva and suspended by a similar colored stalk. Digital vaginal examination indicated that the stalk of tissue extended up into the cervix and beyond. Due to the grossly necrotic appearance, the stalk of tissue was ligated, and the sac was removed. Three puppies were delivered vaginally, but a subsequent caesarian section was required due to uterine inertia likely secondary to exhaustion. Three more live puppies were delivered via the c-section. Further abdominal exploration revealed a tear in the left vaginal wall, one ligated ureter, and the second ureter free at its distal end and leaking urine into the abdomen. The surgical findings indicated that the bladder, ureters, and urethra had herniated through the vaginal tear and prolapsed through the vulva. [source]


Can antenatal education influence how women push in labour?

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2009
A Pilot Randomised Controlled Trial on Maternal Antenatal Teaching for Pushing in Second Stage of Labour (PUSH STUDY)
Background:, Antenatal education on the physiology of second stage of labour and effective pushing has not been studied in the literature. Anecdotal observation seems to indicate that some nulliparous women are (at least initially) unable to push effectively. A large proportion seem to reflexly contract the levator ani muscle when asked to push which may have the effect of slowing the progress of labour. Aims:, To test the effectiveness of structured antenatal education for pushing in the second stage of labour versus normal care and its impact on delivery outcome. Methods: One hundred nulliparous women between 35 and 37 weeks gestation were randomised. Intervention: Two 15-min structured education sessions, one week apart, utilising observation of the perineum and a vaginal examination to teach correct technique for relaxing the levator ani muscle and effective pushing. Results:, In both groups, 31 of 50 women (62%) delivered vaginally. Instrumental delivery and caesarean section rates did not differ between the two groups (P = 0.78, relative risk = 1). The mean duration of active second stage for the control group was 53.96 min compared with 57.26 min for the intervention group. This difference of 3.3 min was not statistically significant (P = 0.56). Knowledge of women in the intervention group was increased and the majority of women found the educational sessions helpful. Conclusion:, Antenatal teaching to ensure effective maternal pushing in labour did not result in altered obstetric outcomes relative to the control group. However, there was a measurable qualitative effect from the intervention in that women clearly felt the education sessions to be helpful. [source]


71 2005 Australia and New Zealand female urology survey: where are we and where are we going?

BJU INTERNATIONAL, Issue 2006
S. PILLAY
Introduction:, Historically Urologists have had more training in the management of incontinence than prolapse, yet these conditions often coexist. As public hospitals perform less elective surgery there is an erosion of trainee exposure to female urology. Do Urological Society members see incontinence and prolapse as important areas for Urologists to continue managing? Methods:, A survey was sent to all Urologists and Trainees in Australia and New Zealand about training, current practice and interest in female urology. Results:, Sixty-nine per cent perform SUI surgery in current practice, and 94% of these had exposure to SUI surgery during their training. 50% of those performing SUI surgery would have liked more training, and 99% believe Urologists should be able to perform SUI surgery. 23% perform prolapse surgery in current practice, and 52% of these had exposure to prolapse surgery during their training. 55% of those performing prolapse surgery would have liked more training. 92% believe Urologists should be able to competently assess women for prolapse and 76% believe Urologists should be able to perform prolapse surgery. 51% have a chaperone present when performing vaginal examination and greater than 50% indicated an interest in attending workshops in female urology. 99% believed trainees should be trained in female urology, and 67% believed there should be a fellowship in female urology. Conclusions:, Most believe Urologists should manage incontinence and prolapse. Many wish they had more training in this area. Female urology fellowships are widely supported. There is sufficient interest to run workshops in this area. [source]


Role of a second stage partogram in predicting the outcome of normal labour

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2009
Jayati K. BASU
Background: Management of the second stage of labour is dictated by arbitrary time limits rather than true measures of progress. No partogram is available for second stage of labour. Objectives: To evaluate a partogram designed for use for the second stage of labour. Methods: This prospective cross-sectional analytical study included low-risk pregnant women with singleton fetuses with vertex presentations at term. From onset of the second stage, vaginal examinations were performed every 30 min until delivery. A scoring system developed by Sizer et al. was used based on station and position of fetal head. Scores were plotted on a second stage partogram and used to predict labour outcomes, such as duration of second stage and mode of delivery. Results: Of 79 women examined, 73 had spontaneous vaginal delivery. Of the remaining six, four required oxytocin infusion and other two required vacuum extraction. The median durations of the second stage of labour for primigravidas (n = 34) and multigravidas (n = 45) were 35 and 25 min, respectively. The median Sizer's partogram score at the onset of second stage was 4. Multiple regression analysis showed that the partogram score (r2 = 0.27) and gravidity (r2 = 0.10) were independent predictors of duration of the second stage. There was a significant association between second stage progress plotted to the right of the partogram line and non-spontaneous delivery (P = 0.01). Conclusion: The second stage partogram score at onset can predict the duration of second stage. Poor progress plotted on the partogram is associated with non-spontaneous delivery. [source]