MBBS OSCE · Obstetrics & Gynaecology
OSCE — Normal Labour and Delivery
Eight-minute OSCE station on Normal Labour and Delivery: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Normal Labour and Delivery.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Normal labour = physiological expulsion of fetus, placenta, and membranes after 24 weeks gestation, via regular painful uterine contractions causing progressive cervical effacement, dilatation, descent, and expulsion. Four stages: 1st (latent 0 to 4cm + active 4 to 10cm), 2nd (full dilatation to baby), 3rd (placenta, active vs expectant management), 4th (golden hour). Eight cardinal movements: engagement, descent, flexion, internal rotation, extension, restitution, external rotation, expulsion. Three Ps: Powers, Passenger, Passage. Molecular switch: myometrial connexin-43 gap junctions plus oxytocin receptor upregulation. Active management of 3rd stage (oxytocin 10 IU IM + CCT + uterine mass
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Fetal distress on CTG (late decelerations, bradycardia, sinusoidal pattern) = ur |
| Safety | Cord prolapse: immediate C-section, elevate presenting part, knee-chest or Trend |
| Safety | Shoulder dystocia: call for help, McRoberts manoeuvre plus suprapubic pressure w |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.