Biomaterial Database

Comparing bimanual pelvic examination to ultrasound measurement for assessment of gestational age in the first trimester of pregnancy. 2002

Mark Nichols, and Elizabeth Morgan, and Jeffrey T Jensen

Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA. nicholsm@ohsu.edu

OBJECTIVE To compare the accuracy of bimanual pelvic examination to ultrasound in the assessment of gestational age and to evaluate resident and faculty accuracy, and residents' learning to perform pelvic examination. METHODS Prospective, blinded, descriptive, correlational study of clinical bimanual examination versus ultrasound dating pregnancy prior to first-trimester abortion. Women scheduled to undergo abortion received transvaginal ultrasound assessment of gestational age. A resident and faculty physician, blinded to the ultrasound results, each performed a pelvic examination immediately prior to the procedure. The pelvic examination assessments were compared to the ultrasound calculations of gestational age. The absolute value of the difference between the bimanual examination and ultrasound dating were compared using the paired t test. Linear regression was used to evaluate the learning of residents. RESULTS The pelvic examination agreed with the ultrasound (+/- 2 weeks) in 92% of cases for faculty and 75% for residents. Accuracy of the resident examinations did not change over their two-month rotations. CONCLUSIONS If pelvic examination alone is used to assess gestational age in the setting of first-trimester abortion, 8% of patients may experience unnecessary interventions, possibly leading to a greater risk of complications.

UI	MeSH Term	Description	Entries
D007396	Internship and Residency	Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities.	House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D009774	Obstetrics	A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.
D010808	Physical Examination	Systematic and thorough inspection of the patient for physical signs of disease or abnormality.	Physical Exam,Examination, Physical,Physical Examinations and Diagnoses,Exam, Physical,Examinations, Physical,Exams, Physical,Physical Examinations,Physical Exams
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011261	Pregnancy Trimester, First	The beginning third of a human PREGNANCY, from the first day of the last normal menstrual period (MENSTRUATION) through the completion of 14 weeks (98 days) of gestation.	Early Placental Phase,Pregnancy, First Trimester,Trimester, First,Early Placental Phases,First Pregnancy Trimester,First Pregnancy Trimesters,First Trimester,First Trimester Pregnancies,First Trimester Pregnancy,First Trimesters,Phase, Early Placental,Phases, Early Placental,Placental Phase, Early,Placental Phases, Early,Pregnancies, First Trimester,Pregnancy Trimesters, First,Trimesters, First
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D002983	Clinical Competence	The capability to perform acceptably those duties directly related to patient care.	Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D004503	Education, Medical, Graduate	Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree.	Medical Education, Graduate,Education, Graduate Medical,Graduate Medical Education
D005260	Female		Females
D005865	Gestational Age	The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination.	Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages