Diagnostic and therapeutic capabilities of ultrasound in the management of pelvic pain

Okaro, E.; Condous, G.

doi:10.1097/01.gco.0000191902.07439.19

Cited by 9 publications

(10 citation statements)

References 57 publications

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“…The TVUS findings were determined by blinded observers using objective criteria. These criteria are reliable and have been proven useful for diagnosing specific gynecologic emergencies [9,10,13,15,21]. …”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, experience is a key factor in the ability of transvaginal ultrasound to manage women with pelvic pain with accuracy [9]. Nonetheless, in our center, we made important efforts to implement a standardized ultrasonography protocol [11] to reduce the heterogeneity of the quality of ultrasonography performed by residents.…”

Section: Discussionmentioning

confidence: 99%

“…Since the 1990s, transvaginal ultrasonography (TVUS) has become an essential diagnostic tool for gynecologic emergencies [9]. Nonetheless, the impact of around-the-clock access to TVUS in gynecologic EDs remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Routine ultrasound examination by OB/GYN residents increase the accuracy of diagnosis for emergency surgery in gynecology

et al. 2013

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IntroductionDiagnostic accuracy of first-line sonographic evaluation by obstetrics/gynecology residents in determining the need for emergency surgery in women with acute pelvic pain is unknown. Aim of this study was to evaluate the diagnostic accuracy of routine ultrasound evaluation by obstetrics/gynecology residents, available 24 hours a day, in patients with acute pelvic pain.MethodsA cross-sectional retrospective study included consecutive patients who underwent emergency laparoscopy for acute pelvic pain at a teaching hospital gynecologic emergency unit, between January 1, 2004, and December 31, 2006. The laparoscopic diagnosis was the reference standard. Gynecologic and nongynecologic conditions requiring immediate surgery to avoid severe morbidity or death were defined as surgical emergencies. In all patients, obstetrics/gynecology residents routinely performed clinical examination and standardized ultrasonography was routinely recorded. Sonograms were re-interpreted for the study, blinded to physical examination and laparoscopic findings, according to evidence-based predetermined criteria. Sensitivity, specificity, and likelihood ratios were computed for clinical data alone, sonographic data alone, and the combination of both.ResultsEmergency laparoscopy was performed in 234 patients, diagnosing 139 (59%) surgical emergencies. Clinical and sonographic examinations performed by the residents each independently predicted a need for emergency surgery. Combining both examinations was superior over each examination alone and had an acceptable false-negative rate of 1%.ConclusionsFirst-line combined clinical and sonographic examination by obstetrics/gynecology residents is effective in ruling out surgical emergencies in patients with acute pelvic pain.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Routine ultrasound examination by OB/GYN residents increase the accuracy of diagnosis for emergency surgery in gynecology

et al. 2013

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“…La pratique des échographies aux urgences gynécologiques est reconnue comme très opérateur dépendant [18]. Ces coupes standardisées sont une approche fondée sur une échographie de niveau limité, rapide, accessible 24 h/24 et réalisé par du personnel médical non titulaire du diplôme d'échographie.…”

Section: Principes Et But De La Standardisationunclassified

Standardisation de l’échographie aux urgences gynécologiques

Popowski

Huchon

Fathallah

et al. 2012

Gynécologie Obstétrique & Fertilité

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“…Sonographic techniques, including transvaginal sonography, have been proven effective in identifying disorders responsible for gynecologic emergencies 1 , 2 . In women presenting to emergency departments (EDs) because of symptoms in the first trimester of pregnancy, sonography is recommended as part of the initial workup 3 , 4 .…”

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confidence: 99%

Impact of Accreditation Training for Residents on Sonographic Quality in Gynecologic Emergencies

Popowski

Huchon

Fathallah

et al. 2015

J of Ultrasound Medicine

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onographic techniques, including transvaginal sonography, have been proven effective in identifying disorders responsible for gynecologic emergencies. 1,2 In women presenting to emergency departments (EDs) because of symptoms in the first trimester of pregnancy, sonography is recommended as part of the initial workup. 3,4 According to a recent systematic review, the use of sonography in gynecologic EDs decreases the risk of missed ectopic pregnancy, time to surgery for ectopic pregnancy, and length of stay in patients with normal pregnancies and may be more cost-effective than diagnostic strategies requiring formal sonography. 5 Abbreviations ED, emergency department; Ob/Gyn, obstetrics and gynecology S ©2015 by the American Institute of Ultrasound in Medicine | J Ultrasound Med 2015; 34:829-835 | 0278-4297 | www.aium.org ORIGINAL RESEARCH Objectives-To assess the impact of an educational intervention based on an original accreditation training program on the quality of emergency sonography performed by obstetrics and gynecology (Ob/Gyn) residents. Methods-We conducted a prospective before-after study on residents who performed bedside standardized sonographic examinations as first-line investigations in patients seen at our gynecologic emergency department. In both periods, the residents followed a 1-hour class taught by a board-certified Ob/Gyn sonography expert (opinion leader) and received a written standardized imaging protocol. An accreditation training process was implemented for the new residents at the beginning of the second period: 5 complete sonographic examinations were required for each resident, and facilitated feedback from the opinion leader was performed using a dedicated sonographic quality score. During both periods, all consecutive sonograms were collected and stored. The primary outcome was the sonographic quality score. A mixed model for repeated measures was used to compare scores in both periods from 20 consecutive sonographic examinations performed by 5 residents who were different in each period. Results-The mixed model analysis showed an increase in quality scores in the post-accreditation training compared to the pre-accreditation training period (estimated coefficient ± SD, 4.13 ± 0.51; t = 8.16). The sonographic examination order also had a significant effect in both periods (estimated coefficient ± SD, 0.11 ± 0.03; t = 3.99). Conclusions-An accreditation training process including facilitated feedback from a local opinion leader improved the quality of sonographic examinations performed by Ob/Gyn residents in women presenting to a gynecologic emergency department.

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Diagnostic and therapeutic capabilities of ultrasound in the management of pelvic pain

Abstract: Experience is a key factor in the ability of transvaginal ultrasound to characterize common gynaecological disorders with accuracy. Therapeutic ultrasound provides an alternative to surgery.

Cited by 9 publications

References 57 publications

Routine ultrasound examination by OB/GYN residents increase the accuracy of diagnosis for emergency surgery in gynecology

Routine ultrasound examination by OB/GYN residents increase the accuracy of diagnosis for emergency surgery in gynecology

Standardisation de l’échographie aux urgences gynécologiques

Impact of Accreditation Training for Residents on Sonographic Quality in Gynecologic Emergencies

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