| Review article: the use of pelvic examination within the emergency department in the assessment of early pregnancy bleeding. | |
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MedLine Citation:
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PMID: 20002713 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Early pregnancy bleeding is a common presentation in the emergency setting. Traditionally, its assessment relied on clinical findings, including pelvic examination. However in recent years, ultrasonography and quantitative beta human chorionic gonadotropin assays have gained prominence and are now first-line in diagnosing early pregnancy bleeding. Accordingly, the role of pelvic examination in the acute setting has been increasingly questioned. This article reviews the evidence for the role of pelvic examination in the assessment of early pregnancy bleeding in the ED. A Medline search was conducted and 43 articles were included in this review. Applicable research is largely observational and of a low level of evidence. However, available data indicate that the role of pelvic examination in the assessment of early pregnancy bleeding is limited, providing that there is prompt access to transvaginal ultrasound examination. Pelvic examination does not provide further diagnostic information over ultrasonography used in conjunction with beta human chorionic gonadotropin assays. The routine use of pelvic examination is not supported by the literature. However, when ultrasonography and beta human chorionic gonadotropin testing are unavailable or the results inconclusive, pelvic examination should be considered. Assessment in these instances must focus on identifying possible life-threatening conditions, such as ectopic pregnancy, as well as determining the safety of discharge pending definitive assessment. Speculum examination is indicated in those presenting with severe bleeding or hypotension as removal of obstructing endocervical products can be a crucial resuscitative measure. |
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Authors:
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Katherine Isoardi |
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2001753 - Progesterone production in early pregnancy. 465383 - Serum follicle stimulating hormone levels in human pregnancy. 6137493 - Pregnancy-associated changes in the thyroid-stimulating antibody of graves' disease and... |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Emergency medicine Australasia : EMA Volume: 21 ISSN: 1742-6723 ISO Abbreviation: Emerg Med Australas Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101199824 Medline TA: Emerg Med Australas Country: Australia |
Other Details:
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Languages: eng Pagination: 440-8 Citation Subset: IM |
Affiliation:
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Emergency Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia. katherineisoardi@yahoo.com.au |
Export Citation:
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Descriptor/Qualifier:
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| Comments/Corrections | |
Comment In:
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Emerg Med Australas. 2010 Jun;22(3):254
[PMID:
20590790
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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