Saturday, March 23, 2013

Bishop score

Bishop score The total score is achieved by assessing the following five components on vaginal examination. 1. cervical dilation
2.Cervical effacement
3. Cervical consistency
4. Cervical position
5. Fetal station
  Cervical dilation – This is the measurement of the opening of the cervix. It is measured in centimeters from 0-10.
  Cervical effacement - This is the measurement of the thinness and shortening of the cervix as it stretches open. It is measured in percentage from 0-100%.

  Cervical consistency This refers to the perceived feeling of the cervix. An unfavorable cervix will feel hard, like the tip of your nose. A more favorable, soft cervix will feel your bottom lip or inside of your cheek.

  Cervical position – Before the onset of labor, the cervix is usually high and facing back in an posterior position behind the baby’s head. As the body is getting ready for labor the cervix will drop lower and move more into a forward-facing anterior position.

  Fetal station This is the measurement of the baby’s position in relationship to the ischial spines of the pelvis. The ischial spines are marked “0″, above the spine is measured in “+” and below in “-”.


 

They can be remembered with the mnemonic: Call PEDS For Parturition = Cervical Position, Effacement, Dilation, Softness; Fetal Station.

 Another modification for the Bishop's score is the modifiers. Points are added or subtracted according to special circumstances as follows:
 One point is added for:
1. Existence of pre-eclampsia
 2. Every previous vaginal delivery
 One point is subtracted for:
 1. Postdate pregnancy
 2. Nulliparity (no previous vaginal deliveries)
 3. PPROM; preterm premature (prelabor) rupture of membranes
If the bishop’s score is-

*less than 6 not favourable for induction.
* 7 to 9 favourable for induction.
*greater than 9 no need for an induction, already in early labour.





Tuesday, March 19, 2013

Babinski sign

A Babinski sign in an older child or adult is abnormal. It is a sign of a problem in the central nervous system (CNS), most likely in a part of the CNS called the pyramidal tract. Asymmetry of the Babinski sign -- when it is present on one side but not the other -- is abnormal. It is a sign not merely of trouble but helps to lateralize that trouble (tell which side of the CNS is involved). The Babinski sign is known by a number of other names: the plantar response (because the sole is the plantar surface of the foot), the toe or big toe sign or phenomenon, and the Babinski reflex, response or phenomenon.

Wednesday, March 13, 2013

https://docs.google.com/file/d/0B7mmHV74rZjnX1U0Z2xvUmpVbDQ/edit?usp=sharing