Nichols Mark, Morgan Elizabeth, Jensen Jeffrey T
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
J Reprod Med. 2002 Oct;47(10):825-8.
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.
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.
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.
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.
比较双合诊盆腔检查与超声检查在评估孕周方面的准确性，评估住院医师和教员的准确性，以及住院医师进行盆腔检查的学习情况。
一项前瞻性、盲法、描述性、相关性研究，比较临床双合诊检查与孕早期流产前超声确定孕周的情况。计划进行流产的女性接受经阴道超声孕周评估。一名住院医师和一名教员在不知道超声结果的情况下，在手术前立即进行盆腔检查。将盆腔检查评估结果与超声计算的孕周进行比较。使用配对t检验比较双合诊检查与超声孕周之间差异的绝对值。采用线性回归评估住院医师的学习情况。
教员进行的盆腔检查在92%的病例中与超声检查结果相符（±2周），住院医师的相符率为75%。住院医师在两个月的轮转期间检查准确性没有变化。
如果在孕早期流产时仅使用盆腔检查来评估孕周，8%的患者可能会经历不必要的干预，可能导致更高的并发症风险。
