Obstet Gynecol. 2018 Oct;132(4):e181-e186. doi: 10.1097/AOG.0000000000002897.
A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks. Given the shifting and complex landscape of care, in which many women may not receive all the recommended preventive services, obstetrician-gynecologists have an opportunity to contribute to the overall health and well-being of women throughout the lifespan by providing recommended preventive services and counseling. Taking a comprehensive history (specifically obtaining detailed information on symptoms and past medical and gynecologic history) will inform if certain components of the physical examination, including breast or pelvic examination, are indicated at that visit and will inform shared decision making for these examinations. Family history should be used as a risk assessment tool and should be completed and updated regularly to ensure the most comprehensive assessment of a woman's personal risk factors. Another key component of a well-woman visit for a reproductive-aged woman is the development and discussion of her reproductive life plan to ensure that medical testing and treatments provided are aligned with her current and future plans. Obstetrician-gynecologists provide care for women across the lifespan, and periodic well-woman visits are appropriate and necessary for perimenopausal women and postmenopausal women as well. This Committee Opinion has been revised to reflect updated guidance on components of the physical examination and new sources for well-woman preventive services.
妇女保健就诊为患者提供了一个绝佳的机会,可对其进行保持健康生活方式和降低健康风险的指导。鉴于医疗护理的不断变化和复杂性,许多女性可能无法获得所有推荐的预防服务,因此妇产科医生有机会通过提供推荐的预防服务和咨询来促进女性的整体健康和福祉。通过全面的病史采集(特别是详细了解症状以及过去的医疗和妇科病史),可以确定该就诊时是否需要进行某些体检内容(包括乳房或盆腔检查),并为这些检查提供共同决策依据。家族史可用作风险评估工具,应定期完成和更新,以确保对女性个人风险因素进行最全面的评估。对于育龄妇女的另一个妇女保健就诊的关键组成部分是制定和讨论其生殖生活计划,以确保提供的医疗检查和治疗符合其当前和未来的计划。妇产科医生为整个生命周期的女性提供护理,因此,对于围绝经期和绝经后女性,定期的妇女保健就诊是适当和必要的。本委员会意见经过修订,以反映体检内容的更新指导和妇女保健预防服务的新来源。