Transvaginal Pelvic Ultrasound in the ED

Hennepin Healthcare Research Institute114 enrolled

Overview

Pelvic ultrasound is frequently performed in the ED in non-pregnant women to assess for ovarian pathology, though its use has not been described in the medical literature. This observational study aims to describe its use in clinical ED practice.

Pelvic ultrasound is frequently performed in the ED in non-pregnant women to assess for ovarian pathology. During the pelvic examination a transvaginal ultrasound probe is used to visualize ovarian size, determine echotexture, assess whether ovarian tenderness is present, and sometimes measure ovarian blood flow. Though pelvic ultrasound is used in the Hennepin County Medical Center ED routinely, there is a paucity of literature assessing it's utility. This observational study will help determine the usefulness of this imaging modality, and how often it changes management in clinical practice. Specifically, this study will attempt to determine how often transvaginal ultrasound identifies the structures of interest, and then will correlate these findings with the final ED diagnosis. If a formal ultrasound is obtained, the findings of the ED ultrasound will also be compared to the findings of the formal ultrasound. The treating physicians will be queried the diagnosis and management plans before and after the pelvic US to ascertain changes in management.

Study Type

OBSERVATIONAL

Enrollment

114

Conditions

Abdominal Pain Pelvic Pain

Interventions

Pelvic USOTHER

To be eligible for inclusion, a woman will have pelvic US completed as part of her ED stay. This is a non-interventional study.

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \>= 18 years old female * ED bedside transvaginal ultrasound to be performed in a non-pregnant woman with at least one ovary * Willing to discuss how they are doing at 7-10 days via phone * Valid phone number Exclusion Criteria: * If a diagnosis of ovarian torsion, mass, TOA or other ovarian pathology is known before ED ultrasound * Previously enrolled in this study

Locations (1)

Hennepin County Medical Center

Minneapolis, Minnesota, United States

Outcomes

Primary Outcomes

Change in diagnosis before/after pelvic US

The treating physician will be queried the likelihood of EMERGENT and NON-EMERGENT ovarian pathology before and after pelvic US using the following scale: Definite, Probable, Possible, Very Unlikely. The ED tests reviewed before each of these judgements will be noted. EMERGENT is defined as ovarian torsion or tubo-ovarian abscess (TOA). NON-EMERGENT is defined as all other causes, including ovarian cyst, ovarian mass, ovarian malignancy, adnexal mass). The clinician will also free text the most likely diagnosis. A change of two or more levels (eg definite to possible, definite to very unlikely, probable to very unlikely, or vice versa) will be assumed to be a significant change in diagnosis.