Government College of Nursing Somajiguda,
Hyderabad, T.S
Procedure Manual for Obstetrics and
Gynecological Nursing
, INDEX
S.no Procedure P.no.
01 Female Pelvis 1-3
02 Fetal Skull 4-6
03 Antenatal Assessment 7-14
04 Pervaginal Examination 15-20
05 Artificial Rupture Of Membranes 21-23
06 Conducting Normal Delivery 24-30
07 Partograph 31-35
08 Episiotomy Giving And Repairing 36-41
09 Management of Third Stage Labour 42-45
10 Placental Examination & Cord Abnormalities 46-49
11 Assisted Breech Delivery 50-56
12 Assisting for LSCS 57-60
13 Assisted Forceps Delivery 61-62
14 Assisted Vaccum Delivery 63-65
15 Post natal Assessment 66-70
16 Perineal Care 71-74
17 Immediate / Essential Newborn Care 75-77
18 Newborn Assessment 78-85
19 Baby Bath 86-90
20 Breastfeeding 91-94
21 Kangaroo Mother Care 95-100
22 Photo Therapy 101-106
23 Newborn Resuscitation 107-113
24 Formulas for Drug Calculation 114-115
25 MTP setup 116-121
26 Insertion and Removal of IUCD 122-131
27 Tubectomy 132-133
28 Pap-smear 134-136
, 1. FEMALE PELVIS
Definition:
Pelvis is key to midwifery practice as one of the way to estimate a woman‘s
progress in labour is by assessing the relationship of the fetus to certain pelvic
landmarks from the obstetrical standpoint.
Functions:
The primary function of the pelvic girdle is to allow movement of the body,
especially walking & running.
This makes it necessary for the sacroiliac joint to be immensely strong
and virtually immobile.
The pelvis also takes the weight of the sitting body on to the ischial
tuberosities.
The female bony pelvis is divided into:
• False pelvis: above the pelvic brim and has no obstetric importance.
• True pelvis: below the pelvic brim and related to the child -birth.
1. The Pelvic Inlet (Brim) Boundaries
1. Upper border of the symphysis pubis.
2. Pubic crests
3. Pubic tubercle
4. Upper border of the superior pubic rami,
5. Ilio-pectineal eminences,
Figure-1: Bony landmarks for the brim of
6. Ilio-pectineal lines,
pelvis
7. Sacroiliac joints,
8. Anterior border of ala of the sacrum,
9. Sacral promontory,
Pelvis is composed of:
- 2 Innominate or hip bones and pubic bone
- 1 Sacrum
- 1 Coccyx
Pelvic joints
1) 1Symphysis pubis (between two pubic bones)
2) 2 Sacroiliac articulation (between sacrum and iliac bones)
3) 1 Sacro-coccygeal joint(between sacrum and coccyx)
1
, Pelvis Diameter
Anterior -posterior Transverse Oblique
Pelvic inlet 11 13 12
Pelvic cavity 12 12 12
Pelvic outlet 13 11 --
Antero-posterior diameters of inlet is of three types:
1) Obstetric conjugate = 10cm
2) True conjugate= 11cm
3) Diagonal conjugate = 12cm
Extra edge for the viva:
Largest diameter of the fetal skull: Mento-vertex (14cm) and smallest
diameter is bimastoid diameter (7.5)
Diameters of engagement for fetal skull in normal labor are:
- Subocciouto bregmatic (9.5cm)
- Subocciputo fontal (10cm) as anterioposterior diameter.
- Bitemporal (9.5cm) as transvers diameter.
Importance of suture:
Permits gliding movements of skull bones for its moulding during the
labour.
Gives an idea of manner engagement by means of digital palpation of
sagittal suture through p/v examination shows degree of rotation of head
shows degree of moulding.
Moulding: It is an alteration of the shape of the fore coming head while passing
through resistant birth canal during labour.
It is disappears within few hours after birth.
Caput succedaneum: it is the formation of swelling due to stagnation of fluid
in the layers of the skull beneath the girdle of contact.
Types of pelvis:
1) Gynaecoid (50%)
2) Android(20%)
3) Anthropoid(25%)
4) Platypelloid( 5%).
Type of pelvis Shape Important features
Gynaecoid Round or - Normal female pelvis.
transversely oval - The transvers diameter of inlet is
slightly AP diameter
- Sacrum is well curved
- Ischial spines are not prominent
- Sacro sciatic notch is wide
- Supra pubic angle is 90o
2
Hyderabad, T.S
Procedure Manual for Obstetrics and
Gynecological Nursing
, INDEX
S.no Procedure P.no.
01 Female Pelvis 1-3
02 Fetal Skull 4-6
03 Antenatal Assessment 7-14
04 Pervaginal Examination 15-20
05 Artificial Rupture Of Membranes 21-23
06 Conducting Normal Delivery 24-30
07 Partograph 31-35
08 Episiotomy Giving And Repairing 36-41
09 Management of Third Stage Labour 42-45
10 Placental Examination & Cord Abnormalities 46-49
11 Assisted Breech Delivery 50-56
12 Assisting for LSCS 57-60
13 Assisted Forceps Delivery 61-62
14 Assisted Vaccum Delivery 63-65
15 Post natal Assessment 66-70
16 Perineal Care 71-74
17 Immediate / Essential Newborn Care 75-77
18 Newborn Assessment 78-85
19 Baby Bath 86-90
20 Breastfeeding 91-94
21 Kangaroo Mother Care 95-100
22 Photo Therapy 101-106
23 Newborn Resuscitation 107-113
24 Formulas for Drug Calculation 114-115
25 MTP setup 116-121
26 Insertion and Removal of IUCD 122-131
27 Tubectomy 132-133
28 Pap-smear 134-136
, 1. FEMALE PELVIS
Definition:
Pelvis is key to midwifery practice as one of the way to estimate a woman‘s
progress in labour is by assessing the relationship of the fetus to certain pelvic
landmarks from the obstetrical standpoint.
Functions:
The primary function of the pelvic girdle is to allow movement of the body,
especially walking & running.
This makes it necessary for the sacroiliac joint to be immensely strong
and virtually immobile.
The pelvis also takes the weight of the sitting body on to the ischial
tuberosities.
The female bony pelvis is divided into:
• False pelvis: above the pelvic brim and has no obstetric importance.
• True pelvis: below the pelvic brim and related to the child -birth.
1. The Pelvic Inlet (Brim) Boundaries
1. Upper border of the symphysis pubis.
2. Pubic crests
3. Pubic tubercle
4. Upper border of the superior pubic rami,
5. Ilio-pectineal eminences,
Figure-1: Bony landmarks for the brim of
6. Ilio-pectineal lines,
pelvis
7. Sacroiliac joints,
8. Anterior border of ala of the sacrum,
9. Sacral promontory,
Pelvis is composed of:
- 2 Innominate or hip bones and pubic bone
- 1 Sacrum
- 1 Coccyx
Pelvic joints
1) 1Symphysis pubis (between two pubic bones)
2) 2 Sacroiliac articulation (between sacrum and iliac bones)
3) 1 Sacro-coccygeal joint(between sacrum and coccyx)
1
, Pelvis Diameter
Anterior -posterior Transverse Oblique
Pelvic inlet 11 13 12
Pelvic cavity 12 12 12
Pelvic outlet 13 11 --
Antero-posterior diameters of inlet is of three types:
1) Obstetric conjugate = 10cm
2) True conjugate= 11cm
3) Diagonal conjugate = 12cm
Extra edge for the viva:
Largest diameter of the fetal skull: Mento-vertex (14cm) and smallest
diameter is bimastoid diameter (7.5)
Diameters of engagement for fetal skull in normal labor are:
- Subocciouto bregmatic (9.5cm)
- Subocciputo fontal (10cm) as anterioposterior diameter.
- Bitemporal (9.5cm) as transvers diameter.
Importance of suture:
Permits gliding movements of skull bones for its moulding during the
labour.
Gives an idea of manner engagement by means of digital palpation of
sagittal suture through p/v examination shows degree of rotation of head
shows degree of moulding.
Moulding: It is an alteration of the shape of the fore coming head while passing
through resistant birth canal during labour.
It is disappears within few hours after birth.
Caput succedaneum: it is the formation of swelling due to stagnation of fluid
in the layers of the skull beneath the girdle of contact.
Types of pelvis:
1) Gynaecoid (50%)
2) Android(20%)
3) Anthropoid(25%)
4) Platypelloid( 5%).
Type of pelvis Shape Important features
Gynaecoid Round or - Normal female pelvis.
transversely oval - The transvers diameter of inlet is
slightly AP diameter
- Sacrum is well curved
- Ischial spines are not prominent
- Sacro sciatic notch is wide
- Supra pubic angle is 90o
2
