 INSPECTION

 SPECULUM EXAMINATION

 BIMANNUAL EXAMINATION
 PRELIMINARIES
 TOILETING
 WEAR STERILE GLOVES
 VULVAL TOILETING
 SEPARATING LABIA BY TWO FINGERS
 INTRODUCING MIDDLE AND INDEX
FINGER OF RIGHT HAND WITH
ANTISEPTIC CREAM
 EXAMINE
 CERVIAL DILATATION
 DEGREE OF EFFACEMENT
 STATUS OF MEMBRANES
 PRESENTING PART AND POSITION
 CAPUT OR MOULDING
 STATION OF HEAD
 ONSET OF LABOUR

 PROGRESS OF LABOUR

 FOLOWING RUPTURE OF MEMBRANE

 TO CONFIRM THE ACTUAL COINCIDENCE

OF BEARING DOWN EFFORTS
 LOOK FOR ULCERATION, CONDYLOMATA,
VARICES AND ANY SCARRING

 NOTE FOR DISCHARGE, FULL RECTUM,

VAGINAL STRICTURE, PROLAPSE OF
CORD
 OBSERVE FOR LENGTH AND DILATATION
 MEASURING CERVICAL LENGTH
IT IS THE DISTANCE BETWEEN THE
INTERNAL OS AND EXTERNAL OS.
 THE ENDO CERVICAL CANAL IS 3 CM LONG
WITH UNEFFACED CERVIX.
 IT IS MEASURED IN CENTIMETERS
 IT IS MEASURED BY COMPARING THE
DEGREE OF SEPARATION OF THE FINGERS
ON VAGINAL EXAMINATION, WITH
SEPARATION OF FINGERS ON VAGINAL
EXAMINATION
 FEATURES OF OCCIPUT PPRESENTATION
 POSTERIOR FONTANELLE IS NORMALLY
FELT
 DIAMOND SHAPED STRUCTURE
 FACE PRESENTATION
 INSTEAD OF A FIRM SKULL SOMETHING
SOFT IS FELT
 ORBITAL RIDGES ABOVE EYES FELT
 EARS FELT
 ANTERIOR FONTANELLE FELT
 THE ROOT OF NOSE AND ORBITAL RIDGES
FELT
 SOFT PART FELT
 ANUS AND ISHIAL TUBEROSITIES FORM
STRAIGH LINE
 IT IS THE OVERLAPPING OF FETAL SKULL
BONES AT A SUTURE WHICH MAY OCCUR
DURING LABOUR DUE TO THE HEAD
BEING COMPRESSED AS IT PASSES
THROUGH THE PELVIS