Evidence-Based. Clearly Delivered.
Evidence-Based. Clearly Delivered.
The main outcomes measures of the USPSTF Evidence Report and Systematic Review on the topic of periodic pelvic exams were morbidity, mortality, harms caused by misdiagnoses and diagnostic inaccuracy for gynecologic cancers and conditions. Cervical cancer and STDs were not included. The summary conclusion states
No direct evidence was identified for overall benefits and harms of the pelvic examination as a 1-time or periodic screening test. Limited evidence was identified regarding the diagnostic accuracy and harms of routine screening pelvic examinations in asymptomatic primary care populations.
ACOG continues to recommend that a comprehensive history should guide aspects of the physical exam, such as breast and pelvic examination. In other words, physical exam should be viewed in terms of a comprehensive provider-patient encounter.
The summary recommendations and conclusions include the following
A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks.
The periodic well-woman care visit should include screening, evaluation and counseling, and immunizations based on age and risk factors.
The interval for specific individual services may differ for individual patients, and the scope of services provided may vary in different ambulatory care settings.
Team-based care, including obstetrician–gynecologists, physician assistants, nurse practitioners, and other health care professionals, may facilitate meeting the needs of preventive care for women.
When taking a history, obtain the following
ACOG Committee Opinion 755: Well-Woman Visit
ACOG Comittee Opinion 754: The Utility of and Indications for Routine Pelvic Examination
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