| Pelvic examination is unnecessary in pregnant patients with a normal bedside ultrasound. | |
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MedLine Citation:
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PMID: 20159393 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This study examines the necessity of a formal pelvic examination in patients with early pregnancy-related complaints and an intrauterine pregnancy on bedside ultrasound (US). METHODS: Data were prospectively collected on emergency department (ED) patients presenting with early pregnancy complaints and bedside US evidence of intrauterine pregnancy. All patients received a formal pelvic examination with cervical testing for sexually transmitted pathogens. Disposition decisions based on pelvic examination findings were compared with disposition decisions based on ultrasound findings alone. RESULTS: Over a 13-month period, 50 patients entered the study. Mean estimated gestational age was 8.6 (+ or - 0.4) weeks. Abnormal speculum examination findings included vaginal blood (19 [38%]) and cervical discharge (3 [6%]). Abnormal bimanual findings included adnexal tenderness (6 [12%]) and uterine tenderness (4 [8%]). One patient (2.5%) had a positive antigen test for Chlamydia trachomatis. Emergency department diagnoses were threatened abortion (30 [60%]), intrauterine pregnancy (11 [22]), abdominal pain (8 [16%]), and ovarian cyst (1 [2%]). Three patients (6%) had incidental urinary tract infections. All patients were discharged from the ED. No management changes were made based on the pelvic examination. CONCLUSION: In patients with a US-documented viable pregnancy, the pelvic examination did not contribute to the patient's immediate obstetric treatment. Occult cervical pathogens may be present in these patients. |
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Authors:
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Amanda Seymour; Heather Abebe; Dan Pavlik; Alfred Sacchetti |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 28 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-17 Completed Date: 2010-03-19 Revised Date: 2010-05-14 |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 213-6 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Emergency Medicine, Our Lady of Lourdes Medical Center, Camden, NJ 08103, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Female Humans Pelvis Physical Examination* Point-of-Care Systems Pregnancy Pregnancy Complications / diagnosis*, ultrasonography Pregnancy Trimester, First* Prospective Studies Ultrasonography, Prenatal* United States |
| Comments/Corrections | |
Comment In:
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Am J Emerg Med. 2010 May;28(4):532; author reply 532-3
[PMID:
20466250
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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