During Bartholin glands examination, how should the finger be inserted and palpated?

• A. Insert the index finger at the four- and eight-o'clock positions and palpate with the thumb externally
• B. Palpate with the middle finger from the vaginal apex
• C. Inspect externally only
• D. Use the ring finger at around 3 and 9 o'clock

Answer: (A)

Bartholin glands sit on either side of the vaginal opening, at about the 4 o’clock and 8 o’clock positions in the posterior vestibule. To assess them, insert a gloved index finger into the vestibule at those four- and eight-o’clock points and use the thumb on the exterior to apply gentle counterpressure. This two-handed approach lets you feel the gland through the vaginal wall, checking its size, tenderness, and whether a duct is blocked or an abscess is present. The technique described targets the glands where they naturally lie and uses internal palpation with external support, which is essential for an accurate examination.