The Use of Transvaginal Ultrasound by Emergency Physicians in Medical Student Education

Abstract

Paul L Foster School of Medicine at Texas Tech University Health Sciences Center in El Paso offers the students a faculty (both clinician and basic scientists) guided clinical presentation based curriculum. Emergency physicians have been an integral part of this curriculum. Bedside transvaginal ultrasound has become an adjunct to the history and physical examination for the evaluation in a timely manner of acute pelvic and lower abdominal pain and vaginal bleeding in the female of reproductive years. Discussion of the approach to diagnosis is divided into two broad categories; evaluation when there's a positive pregnancy test (first trimester) and a negative pregnancy test. The discussion also illustrates how the emergency physician can, using ultrasound, introduce, integrate, and review, the pertinent basic sciences (anatomy, embryology, pathology, physiology, microbiology and biochemistry) with the medical student.

Normal and Abnormal Early Pregnancy

“…1 Clinical signs, such as abdominal pain and vaginal bleeding in early pregnancy, are in first line suspicious of spontaneous abortion. Ultrasound supports the differentiation into threatened, incomplete or complete abortion and shows the way to appropriate clinical management.…”