Course Access
Hello Franciska,
Early Pregnancy
* VE is not usually performed
* Exception: to obtain a PAP smear for women
* Reasons for this may be she has never had one (of which there
are still plenty) or women who may be lost to any follow up (due to poor
social circumstances/addiction issues etc.)
Mid Trimester
* Maybe performed to diagnose cervical shortening but this is
usually done under ultrasound which is a clean procedure
3rd Trimester and in labour
While the vagina is not a sterile area, in obstetric patients there is a
real risk of infection by introduced organisms. Multiple VEs are a risk
for chorioamnionitis/puerperal fever
Rupture of membranes is a sterile procedure, as well as attachment of
foetal scalp electrodes.
As I have mentioned, the vagina is not sterile, so the field is prepared
with obstetric cream which contains chlorhexidine
(http://www.sm2015.org/wmSfiles/products/sm2015/documents/website/GRAVET
T_PLoS_Medicine_Mater_al_Infections_2012.pdf)
At birth:
The accoucheur is receiving a baby that has passed through a non-sterile
area; sterile gloves may not be required.
Women birth in amazing settings at times; back of taxis, at home, in an
ambulance, in water.
They no longer have enemas (as they did when I was a new midwife) so
they can defaecate during delivery.
However, having said that, my organisation uses sterile gloves.
This is because:
* the delivery set is sterile,
* All is in readiness if an episiotomy is required.
Gynae procedures
VE is performed a clean procedure. Sterile gloves are not required
unless there is a more invasive procedure being performed at the same
time (e.g. hysteroscopy)
We use re-usable speculums that have been sterilised.
However, many external practices use disposable speculums that are
described on the packaging as clinically clean (not sterile)
I hope this is some use to you.
I am open to further discussion if others disagree.
Maree
Maree Sommerville
Infection Control Coordinator
Mercy Hospital for Women
(03) 8458 4759
________________________________
Behalf Of Franciska Ferreira
Good morning all,
I was asked the question, whether sterile gloves or non-sterile gloves
should be used when conducting VE’s and Deliveries? I have little
knowledge/background in the obstetric field but have witnessed
obstetricians wearing sterile gloves for VE’s in the past.
From recent experience I’ve been told that most obstetricians using
non-sterile gloves and only uses sterile gloves for suturing.
Any comments or views on this matter would be appreciated.
Thank you
Franciska Ferreira
INFECTION PREVENTION & CONTROL /WOUND MANAGEMENT CONSULTANT
Burnside War Memorial Hospital
120 Kensington Road, Toorak Gardens, SA 5056
t: 08 8202 7222 f: 08 8407 8573 e: fferreira@burnsidehospital.asn.au
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