Determination of the term of pregnancy and date of labor.

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Task for students: determine for this pregnant woman, parturient term of pregnancy and date of labor . In the same time to describe of examiner what are you doing.

The time of demonstration is 5 minutes.

Information for the examine:assess, please, the student’s actions, separately, on the every below given item.

1.	Explain for pregnant woman, parturient essence of examination.	1	0,5
2.	Determine the term of pregnancy on the date of the last menstruation (LM). The first day is counted as 0 day, but not as the first . Days from 0 -6 are coordinated as “ full zero moon’s week”, but days fro 7 till 13 – the full the first moon week. If the first day of LM is unknown , the term of pregnancy is counted on the base of the more suitable clinic date..	1	0,5
3.	Determine the term of pregnancy on ovulation. From the first day of waiting but not came menstruation 14 – 16 days should be minus , depending on the continuation of cycle and counting on calendar the term on the day of investigation.	1	0,5
4.	Determine the term of pregnancy on the date of the first of fetus movement . If woman is prime gravid a it is 20 weeks, for malty pare – 18 weeks of pregnancy, after that , using a calendar cunt the term of pregnancy.	1	0,5
5.	For determination of the date of labor among prime gravid woman to the date of the first of fetus movement plus 20 weeks, malty pare – plus 22 weeks.	1	0,5
6.	According to term of pregnancy on the first , with condition – early visit to FDA, female consultation, make exact date of the first visit..	1	0,5
7.	According to objective date , counting the circumference of abdomen index and height of fundus and date of bi – manual examination in the term of pregnancy below 12 weeks..	1	0,5
8.	Determine a term of pregnancy according to USI date in condition of the first examination till 16 weeks.	1	0,5
9.	Determine date of labor on the Nigella formula : from the date of the first day of last menstruation minus 3 months and add 7 days..	1	0,5
10.	In the counting of the term of pregnancy should be count as days , as a weeks. According to receive date to make a conclusion about the term of pregnancy and possible date of labor..	1	0,5

Maximum quantity of balls - 10

Determination of the possible of fetus mass.

Task for students : determine for the patient a possible mass of fetus. In the same time to describe of examiner what are you doing.

The time of demonstration is 5 minutes.

Information for the examine:assess, please, the student’s actions, separately, on the every below given item

1	Explain for pregnant woman, parturient essence of examination. Hands, dry with disposable towel Take on a disposable gloves.	1	0,5
2	Take a sizes of circumference of abdomen (CA) on the level of umbilicus and lateral angle of Michaels rhombus with belt.	1	0,5
3	Measure the height of uterine fundus standing with sm. -. The beginning of belt is on the upper edge of pubic articulation, belt should be situated on the middle line of abdomen. With a rubber of a palm we determine height of fundus in centimeters.	1	0,5
4	Determination of the fetus mass according to Zordania method., us multiplication of circumference of abdomen on the height of fundus . .	1	0,5
5	Determination of the possible fetus mass according to S, according to formula: Х = Mass of woman in grams/ on constant ( depending on a mass of woman) + (CA´ HUF 2	1	0,5
6	Determine a mass of fetus according to Yakubova ‘s method prime gravid, head presentation, the whole amniotic membranes mass of fetus is = (CA+ HUF )´100 4 In case of the 2^nd labor +50, 4-th+150, more+300.	1	0,5
7	Determination of fetus mass according to Jonson method: (HUF-11)´155	1	0,5
8	Determination of fetus mass on Bublichenko method . Possible mas of fetus is 1/20 body mass of a woman	1	0,5
9	In cases of prognosis of big baby mass of fetus is determine on Nurcasymov method ( for doctors in internship)	1	0,5
10	On the base of received date to make a conclusion about possible mass of fetus . Remove a gloves and through its in special container for utilization., wash a hands.	1	0,5

Maximum quantity balls is 10.

The notice.

Constant at definition of fetus mass on the method of Stroykova.

K- weight up to 51 kg -15

51-53 = 16

54-56 = 17

57-62 = 18

63-65 = 19

66-73 = 20

74-81 = 21

81 and more = 22

Filling of partogram.

Task for students: Describe the rules of partogram filling.

Time of skill description is 10 minutes.

Information for examiner : assess, please, with counting criteria of practical skills of partogram filling on a base of the represented date.

1.	At the upper part of partogram is fixated name, surname of parturient, obstetrical dates ( quantity of labor, pregnancies) in anamnesis), № of case of labor , date and time of hospitalization to the stationary( maternity home) , period without amniotic fluid ( in hours ), time of partogram filling started.	1	0,5
2.	The dilatation of uterine cervix is filling as "X" on graphic. Latent phase – period of slowly dilatation of uterine cervix from 0 till 3 sm.,with constant shortness of uterine cervix . Active phase is period of fast of uterine cervix dilatation from 3 till 10 sm. Dilatation of cervix from 0 – 3 sm. , is reflected of latent period of labor , in cases of going labor to active phase , reflection of dilatation uterine cervix we put on Alarming line on a way of interrupted line. If woman is in an active phase of dilatation of uterine cervix , we put on Alarming ;line with coordination of the degree dilatation and time we put exact under the place of X. on the “ time “ line.	1	0,5
3.	Contractions of uterus are reflected with interrupted lines : points, oblique lines and not interrupted lines below the axis of time , where is written “ contractions of uterus “.during 10 minutes . Every small part is coordinated with from 1 to 5. Every small part is coordinated with one contraction. If during 10 minutes will be 2 contractions , we should use two small parts and etc..	1	0,5
4.	Going down of fetus head is reflected “0” on the left part of graphic on scale “ going down of fetus head “ with mark from 5 till o( situation of head is over the edge of pubis in a wide distance of 5 fingers, head its part which is over the pubic , is measured the smaller quantity of fingers ( 4/5, 3/5 and etc.)	1	0,5
5.	Frequency of fetus heart beating we registries every 30 minutes at the upper part of partogram.	1	0,5
6.	Condition of amniotic fluid is reflected at the graph “ amniotic fluid”.We make registration of the amniotic fluid color : clear amniotic fluid “C”, bloody “ B”< with meconium “ M” < whole membranes “ I”.	1	0,5
7.	Make reflection of a head bones configuration on a place bellow line “ amniotic fluid .If bones separated fro each to other , sutures are palpable , we make fixation ,as “0”; if its touch each other a little (+). If its going over each other ( ++), very serious going over ( +++)	1	0,5
8.	We should reflect prescriptions of oxytocin injections at IU/l or drops . . Prescriptions of another medicine and i/v solutions is reflected on line, below oxytocin reflection.	1	0,5
9.	Supervision of a parturient condition we reflected on partogram below . BP and PS rate is measured ever 1 hour, t-ra every 4 hours. Volume of urine presence of protein and acetone in urine is redistricted too.	1	0,5
10.	During procedure we must explain our actions with temper and friendly tone, give the possibility to ask a questions.	1	0,5

Maximum quantity of balls -10

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