OSCE SCENARIO
Angela Parker presents to maternity triage feeling generally unwell.
She is Day 4 post birth and has her newborn with her. Angela reports
she was seen in the community on day 1 at the midwife’s clinic with
no issues at the time. When you enquire Angela reports no concerns
with her baby who looks well, alert and well perfused with reports of
good breastfeeding. You perform a set of observations on Angela,
test Angela’s urine, review her postnatal discharge summary and
perform a postnatal assessment with Angela’s consent.
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AP
MEDICAL HISTORY
-
-
Recurrent UTI’s
Mild Asthma – not
requiring regular
medication
BMI 35
OBSTETRIC HISTORY
-
SVD 2017 EBL 400mls
2nd degree tear sutured
Active third stage
Female Infant, 3468g
No complications
MEDICATION AT
DISCHARGE
-
-
Ferrous sulphate 200mg
BD – to be reviewed by
GP at 6 weeks
Clexane 80mg OD for
10 days
DISCHARGE SUMMARY
ANGELA PARKER
DISCHARGE SUMMARY
G2 P2
Spontaneous labour @ 37+2 weeks gestation
SVD @ 1634
EBL 1000mls
Episiotomy for fetal distress – sutured
IDC – TWOC passed
High risk VTE
Male Infant
APGAR 9,10,10
Weight at birth: 3840g
Significant meconium at delivery
Vitamin K given IM
Breastfeeding
PU and BO at discharge
NIPE – NAD
Hearing screen – Passed
BLOODS
A POSITIVE
VIROLOGY NEGATIVE
POST DELIVERY HB 99
1
2
3
Day 1 Community Midwife Visit
Angela reports feeling well, no concerns. PU and BO, drinking and eating well. Uterus well contracted
and lochia minimal. Episiotomy site examined with consent, healing well.
Male infant is alert with good tone. PU x2 and BO – meconium seen. Angela reports he feeds on
demand every 3-4 hours. No concerns.
PLAN
Appointment booked for day 5 visit
Angela aware of CMW numbers to call with any concerns
TIRIAGE ASSESSMENT
Urine Test Results:
1+ Blood
Otherwise NAD
Postnatal check:
No Headaches
No Chest pain or shortness of breath
Breasts - NAD
Nipples - NAD
Uterus well contracted
Lochia moderate
Episiotomy site examined with consent – stitches intact, small raised red area noted around the sutured site.
Angela reports this feeling tender.
Legs – NAD
PU – NAD
BO since delivery
Eating and drinking as normal
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