{"id":1704,"date":"2010-12-13T09:36:54","date_gmt":"2010-12-13T09:36:54","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/physical-daignostic-examination\/"},"modified":"2023-09-07T16:35:51","modified_gmt":"2023-09-07T15:35:51","slug":"physical-diagnostic-examination-2","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/obstetrics\/subsequent-check-ups\/physical-diagnostic-examination-2\/","title":{"rendered":"Physical Diagnostic Examination"},"content":{"rendered":"<p>Various parameters and procedures can be used to <span style=\"text-decoration: underline;\">monitor<\/span> the condition of the pregnant woman and <span style=\"text-decoration: underline;\">evaluate<\/span> the <strong>growth<\/strong>, <strong>development<\/strong>, <strong>presentation<\/strong> and <strong>vital functions<\/strong> of the foetus.<\/p>\n<p>The check-up examination in pregnancy includes the following aspects:<\/p>\n<ul>\n<li>General inspection.<\/li>\n<li>Blood pressure measurement.<\/li>\n<li>Determination of weight.<\/li>\n<li>External obstetric examination.<\/li>\n<li>Inspection.<\/li>\n<li>Palpation (<em>determination of fundal height, presentation of the foetus and station of the presenting part<\/em>).<\/li>\n<li>Auscultation of the foetal heartbeat.<\/li>\n<li>Laboratory tests.<\/li>\n<\/ul>\n<h3><\/h3>\n<h3><span style=\"text-decoration: underline;\"><span style=\"color: #000000;\"><strong>General Inspection<\/strong><\/span><\/span><\/h3>\n<p>Evaluate the data from the present situation and the general inspection from the examination performed early in the pregnancy.<\/p>\n<p>Pay specific attention to:<\/p>\n<ul>\n<li>General nutritional status.<\/li>\n<li>Oedema (<em>face, hands, ankles<\/em>).<\/li>\n<li>Increase in or development of varicose veins.<\/li>\n<\/ul>\n<p>To gain an impression of the degree of oedema, <strong>palpate the oedema<\/strong> by <strong>pressing the skin<\/strong> against a <strong>hard sublayer<\/strong> (<em>e.g., the tibia<\/em>) so that a <strong>dimple<\/strong> (<em>pitting oedema<\/em>) forms. Depending on the depth of the dimple, the oedema is referred to as: <strong>+<\/strong>, <strong>++<\/strong>, or <strong>+++<\/strong>.<\/p>\n<p>&nbsp;<\/p>\n<h3><span style=\"text-decoration: underline; color: #000000;\"><strong>Blood Pressure<\/strong><\/span><\/h3>\n<p>During pregnancy, the mother\u2019s <strong>systolic blood pressure<\/strong> (<em>measured on the brachial artery<\/em>) remains virtually <span style=\"text-decoration: underline;\">unchanged<\/span>. The <strong>diastolic blood pressure<\/strong> often falls in the <span style=\"text-decoration: underline;\">second trimester<\/span> by <strong>10-15 mmHg<\/strong> (<em>mid-pregnancy dip<\/em>) and <span style=\"text-decoration: underline;\">rises<\/span> once again in the <span style=\"text-decoration: underline;\">third trimester<\/span> to a pre-pregnancy level.<\/p>\n<p>Both the blood pressure <span style=\"text-decoration: underline;\">level<\/span> and <span style=\"text-decoration: underline;\">any changes<\/span> between two check-ups are important. A s<strong>ystolic blood pressure<\/strong> <strong>\u2265 140 mmHg<\/strong> and\/or a <strong>diastolic blood pressure<\/strong> <strong>\u2265 90 mmHg<\/strong> should generally be defined as <strong>hypertension<\/strong>. However, an increase in blood pressure at a subsequent check up of more than <strong>30 mmHg systolic<\/strong> and\/or <strong>20 mmHg diastolic<\/strong> is also cause for alarm, even if the associated blood pressure remains <strong>below 140\/90 mmHg<\/strong>. If increased blood pressure is measured, the measurement can be repeated after the patient has rested for 10 minutes.<\/p>\n<p>&nbsp;<\/p>\n<h3><span style=\"text-decoration: underline; color: #000000;\"><strong>Weight<\/strong><\/span><\/h3>\n<p>During pregnancy, weight gradually increases by an average of <strong>10 to 12 kg<\/strong>. The cause and physiological significance of this has been considered in &#8220;<em>Changes in the Maternal Body<\/em>&#8220;.<\/p>\n<p>During the first trimester of pregnancy, this weight increase is mostly quite small (<em>average 1.2 kg<\/em>), and during the second trimester it is slightly <span style=\"text-decoration: underline;\">more pronounced<\/span> than in the third trimester.<\/p>\n<p>Excessive weight gain in the second half of the pregnancy (<em>500 g per week measured over three successive weeks<\/em>) is indicative of <strong>interstitial fluid accumulation<\/strong> and precedes <strong>oedema<\/strong> and <strong>gestational hypertension<\/strong>. <span style=\"text-decoration: underline;\">Manifest oedema<\/span> is mainly found in the <em>lower extremities<\/em>, <em>abdominal skin<\/em>, <em>hands<\/em>, <em>face<\/em> and <em>sacrum<\/em>.<\/p>\n<p>Very little or no increase in weight, and certainly a loss of weight, may be indicative of <strong>foetal growth retardation<\/strong>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Various parameters and procedures can be used to monitor the condition of the pregnant woman and evaluate the growth, development, presentation and vital functions of the foetus. The check-up examination in pregnancy includes the following aspects: General inspection. Blood pressure measurement. Determination of weight. External obstetric examination. Inspection. Palpation (determination of fundal height, presentation of [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[57],"tags":[138],"class_list":["post-1704","post","type-post","status-publish","format-standard","hentry","category-subsequent-check-ups","tag-obstetrics"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Physical Diagnostic Examination - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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