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Re: Ultrasound as part of the normal examFrom: Don Miller (drmiller@enatal.com)Sun Mar 13 07:08:22 2005
At Sat, 12 Mar 2005, Garry E. Siegel, M.D. wrote: > >I seem to remember a thought a while ago that doing a vaginal scan >during a routine pelvic exam should be commonplace. It's more than a thought. Steven Goldstein at NYU has been advocating and doing it for over a decade or two (heard him last year at ACOG). It takes about 15 secs to survey the pelvis and current machines are about the size of a laptop and portable. And you know in 15 secs what's going on. IMHO, as someone who personally performed 1,000 ultrasounds a year, vaginal and abdominal, vaginal ultrasound, as an extension, or the primary component of a GYN visit should be the standard of care today. The only reason it isn't (and probably won't be for a decade or so) is because folks don't like to change their routines (and it's NOT the money). Many are apparently satisfied thinking that they're actually accomplishing something when they do a bimanual exam on a 300 pound woman. There are of course the hazards and precautions whenever you talk about routine screening. Any kind of routine testing will have false positives and maybe unnecessary interventions in the hands of those who are unaware of those kind of things (e.g. how many thousands of women had emergency C-sections for variable decelerations when FHR monitoring was introduced?). US has been advocated for ovarian cancer screening in menopausal and not generally recommended in all populations because of public health and cost reasons - not for delivery of best care reasons.
-- Donald W. Miller, Jr., MD, FACOG eNATAL, LLC http://www.eNATAL.com
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