Speedy evaluation The exam method around the globe retains on altering as technology and expertise maintains to conform and increase. the only real aim is ‘improved sufferer care’. the present exam process is basically aimed not just to judge the actual or theoretical wisdom, but additionally the conceptual knowing and the analytical energy of the candidate. To qualify any exam procedure, in addition to the textbook wisdom, a candidate is anticipated to illustrate the abilities of medical exam and knowledge interpretation, the artwork of verbal exchange, decision-making and the administration concerns. With this sole selection the e-book “Bedside Clinics and Viva-Voce in Obstetrics and Gynecology” has been written. This booklet is meant for the scholars at their ultimate section, whereas getting ready for the exam. The booklet has to be learn and reread to increase an effective clutch of every subject because it includes a large wealth of the hot fabric. Key good points • Covers comprehensively the full area of medical, functional and Viva-Voce a part of the exam, satisfying collage path curriculum • solutions are framed in an easy and concise means for simple figuring out and replica • Immensely precious for fast revision of the complete path, to these having a heritage of Textbook wisdom • version solutions are made to lead a candidate the way to write the speculation questions (short questions chapters either in obstetrics and gynecology part) • themes on Ultrasonography, Doppler experiences, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), Laparoscopic and Hysteroscopic surgical procedure, robot surgical procedure were integrated broadly to acquaint a candidate with the development of technology and know-how • SBAs and MCQs are awarded with version solutions for extensive insurance of the topic and to make up the susceptible parts • Exhaustive variety of medical photos, graphs, sketches and line drawings were integrated for higher realizing of inauspicious parts • Authoritative and finished synoptic advisor for the scientific and Viva-Voce a part of the exam • notably, the data is up to date, evidence-based, and the analyzing is straightforward and relaxing.

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We would also do the pelvic assessment and rule out cephalopelvic disproportion at that time. There after partographic monitoring of labor will be done for successful vaginal delivery. However in the presence of any abnormality she would be delivered by cesarean section. Q. How cephalopelvic disproportion is diagnosed? Ans. Cephalopelvic disproportion at the level of the brim is mostly assessed by — (a) clinical methods, (b) imaging pelvimetry. a. Clinical methods i. Abdominal method. It is a good screening method.

Ans. i. Unnecessary cesarean sections are avoided. ii. Successful trial may ensure future good obstetric behavior. Fig. 11: Candidate demonstrates obstetric examination by pelvic grip (Leopold fourth maneuver) Obstetric Case Discussions CASE–3 NORMAL PUERPERIUM Case Summary Mrs SD, aged 23 years, P1 + 0 + 0 + 1, presents with the complaints of pain in the lower abdomen as well as in the perineum. She had been admitted last night with labor pain at the end of her term pregnancy. She was a booked case.

Ans. Vaginal Birth After Cesarean. Obstetric Case Discussions Fig. 15: Scar dehiscence Mrs. CR, 2nd gravida, with prior cesarean delivery was admitted at 38 weeks of pregnancy with pain abdomen. Clinical examination revealed vitals were stable with doubtful scar tenderness. Laparotomy for emergency cesarean delivery revealed scar dehiscence. (See arrows) Q. Who are the women who are not considered for VBAC? Ans. Women with—(i) previous classical cesarean delivery or hysterotomy should be delivered by elective cesarean section after 37 completed weeks, (ii) previous two or more lower segment cesarean section, (iii) contracted pelvis or suspected CPD, (iv) presence of other complications in pregnancy like PIH and malpresentation, (v) in a center where facilities for emergency cesarean delivery are not available round the clock and (vi) patient refusal.

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