Page 77 - fourth year book

MATERNAL AND CHILD HEALTH CARE (MCH)

II. Examination

1. General examination
 Head: ears, and nose, mouth and throat.
 Neck: palpation of the thyroid gland.
 Observation of skin and hair.
 Heart and lungs; are auscultated for irregularities in function.

 Extremities; are examined for varicose veins and oedema.
 Vital signs; temp, pulse, and respiration, to detect any
abnormalities.
 Body weight and height weight should be recorded in the first
visit, then recording the weight in graph each return visits.

2. Local examination
1. Inspection of breast and nipples.
2. Abdominal examination.

 Inspection of hair distribution, linea nigra, stria gravidarum and
scare of previous operations.
 Palpation of the abdomen for:
o Height of the funds.
o Fetal: lie, attitude, position and presentation using the four grips.

3. Auscultation of fetal heart sound (120/160/min).
4. Pelvic measurements.
5. Inspection of external genitalia.
6. Cervix examination (Position, size, mobility).

III. Investigations

1. Urine analysis for glucose and albumen.
2. Blood tests, include:
o Blood group: is determined because of the risk of hemorrhage.
o Rhesus factor, if the mother is Rh-negative, the father should be

typed.
o Hemoglobin, if Hb is below 12.6 g (85%) iron, folic acid and
vitamins B, and C are prescribed. If below 10.3 g (70%) blood
investigation is carried out.
o Wassermann test, for screening of syphilis.

IV. Dental examination.
V. Social services

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