APPENDIX 9.2 - EXAMINATION FORM

IN SPECULO EXAMINATION

 

Signs of cervical surgery:

Ostium visible:

Signs of cervicitis:

Erosion of the portio:

Signs of vaginal inflammation:

Vaginal fluor:

 

BIMANUAL EXAMINATION

 

Height of fundus:

Doubt of existing pregnancy:

Estimated size of uterus (express in weeks amenorrhoea):

Position of uterus (anteflexed, retroflexed etc):

Signs of fibromatous uterus:

Adnexes felt (left, right):

Pain when touching adnexes:

Pain when moving the uterus:

Pregnancy test (not done, negative, positive)

 

ULTRASOUND EXAMINATION

Gestational sac seen:

...................

Yolk sac seen:

...................

Fetus seen:

BPD: ( weeks)

CR:

(weeks)

Uterus filled with homogeneous mass:.......................

(suggests ectopic)

Signs of septum or duplication:

...................

Ovarian cyst seen (size, description):

....................

 

 

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