Pelvic exam in gynecology and obstetrics: Guidelines for clinical practice

被引：5

作者：

Deffieux, Xavier ^{[1
]}

Rousset-Jablonski, Christine ^{[2
,37
,49
]}

Gantois, Adrien ^{[3
]}

Brillac, Thierry ^{[4
]}

Maruani, Julia ^{[5
]}

Maitrot-Mantelet, Lorraine ^{[6
]}

Mignot, Stephanie ^{[7
]}

Gaucher, Laurent ^{[8
,36
,37
,38
]}

Athiel, Yoann ^{[9
]}

Baffet, Hortense ^{[10
]}

Bailleul, Alexandre ^{[11
,39
]}

Bernard, Valerie ^{[12
,22
]}

Bourdon, Mathilde ^{[13
]}

Cardaillac, Claire ^{[14
]}

Carneiro, Yaritza ^{[7
]}

Chariot, Patrick ^{[15
,40
]}

Corroenne, Romain ^{[16
]}

Dabi, Yohann

Dahlem, Laurence ^{[17
]}

Frank, Sophie ^{[18
]}

Freyens, Anne ^{[19
]}

Grouthier, Virginie ^{[20
,41
]}

Hernandez, Isabelle ^{[3
]}

Iraola, Elisabeth ^{[21
,42
]}

Lambert, Marie ^{[12
]}

Lauchet, Nadege ^{[23
]}

Legendre, Guillaume ^{[24
,43
]}

Le Lous, Maela ^{[25
,44
]}

Louis-Vahdat, Christine ^{[26
]}

Sainte-Beuve, Anne Martinat ^{[27
]}

Masson, Marine ^{[7
]}

Matteo, Caroline ^{[28
]}

Pinton, Anne ^{[29
,45
]}

Sabbagh, Emmanuelle ^{[6
]}

Sallee, Camille ^{[30
]}

Thubert, Thibault ^{[31
,46
]}

Heron, Isabelle ^{[32
,47
]}

Pizzoferrato, Anne-Cecile ^{[33
,48
]}

Artzner, France ^{[34
]}

Tavenet, Arounie ^{[35
]}

Le Rayi, Camille ^{[34
]}

Fauconnier, Arnaud ^{[11
]}

机构：

[1] Univ Paris Saclay, Hop Antoine Beclere, Serv Gynecol Obstet, F-92140 Clamart, France

[2] Ctr Leon Berard, Dept Chirurg, 28 Rue Laennec, F-69008 Lyon, France

[3] France Heberge Reseau Sante Perinatal Parisien RS, Coll Natl Sages Femmes, F-75010 Paris, France

[4] Dept Med Gen, F-31000 Toulouse, France

[5] Cabinet Med, 6 Rue Docteur Albert Schweitzer, F-13006 Marseille, France

[6] Hop Univ Paris Ctr HUPC, Hop Port Royal, AP HP, Unite Gynecol Med, F-75014 Paris, France

[7] Dept Med Gen, F-86000 Poitiers, France

[8] CNSF, Coll Natl Sages Femmes France, F-75010 Paris, France

[9] Univ Paris Cite, Grp Hosp Paris Ctr, AP HP, Maternite Port Royal,FHU Prema, F-75014 Paris, France

[10] Univ Lille, CHU Lille, Serv Gynecol Med Orthogenie & Sexol, F-59000 Lille, France

[11] Ctr Hosp Poissy St Germain En Laye, Serv Gynecol Obstet, F-78300 Poissy, France

[12] Ctr Hosp Univ Pellegrin, Ctr Alienor Aquitaine, Serv Chirurg Gynecol Gynecol Med & Med Reprod, F-33000 Bordeaux, France

[13] Univ Paris Cite, Ctr Hosp Univ CHU Cochin Port Royal, AP HP, Serv Gynecol Obstet & Mede Reprod 2, F-75014 Paris, France

[14] CHU Nantes, Serv Gynecol Obstet, F-44000 Nantes, France

[15] AP HP, Dept Med Legale & Sociale, F-93140 Bondy, France

[16] CHU Angers, Serv Gynecol Obstet, F-49000 Angers, France

[17] Univ Bordeaux, Fac Med, Dept Univ Med Gen, 146 Rue Leo Saignat, F-33076 Bordeaux, France

[18] Inst Curie, Serv Oncogenet, F-75005 Paris, France

[19] Univ Paul Sabatier, Dept Univ Med Gen DUMG, F-31000 Toulouse, France

[20] Ctr Hosp Univ Reg Bordeaux, Hop Haut Leveque, Serv Endocrinol Diabetol Nutr & Dendocrinol Gonad, F-31000 Bordeaux, France

[21] Univ Sorbonne Paris Nord, Inst Rech Interdisciplinaire Enjeux Sociaux IRIS, UMR 8156 997, CNRS,U997,Inserm,EHESS,UP13,UFR,SMBH, Paris, France

[22] Univ Bordeaux, Bordeaux Inst Oncol, Unite 1312, Inserm, F-33000 Bordeaux, France

[23] Grp Med Francois Perrin, 9 Rue Francois Perrin, F-87000 Limoges, France

[24] CHU Angers, Serv Gynecol Obstet, F-49000 Angers, France

[25] Univ Rennes 1, INSERM, LTSI, UMR 1099, F-35000 Rennes, France

[26] Cabinet Gynecol & Obstet, 126 Blvd St Germain, F-75006 Paris, France

[27] Cabinet Med, 177 Rue Versailles, F-78157 Le Chesnay Rocquencourt, France

[28] Aix Marseille Univ, Ecole Maieut, F-13015 Marseille, France

[29] Hop Trousseau, AP HP, Serv Gynecol Obstet, 26 Ave Dr Arnold Netter, F-75012 Paris, France

[30] CHU Limoges, Hop Mere Enfant, Serv Gynecol Obstet, F-87000 Limoges, France

[31] CHU Nantes, Serv Gynecol Obstet, F-44000 Nantes, France

[32] Univ Rouen, Hop Charles Nicolle, Serv Endocrinol, F-76000 Rouen, France

[33] Hop Univ La Miletrie, Serv Gynecol Obstet, F-86000 Poitiers, France

[34] Collectif Interassociatif Autour Naissance, Ciane, 101 Rue Pierre Corneille, F-69003 Lyon, France

[35] Assoc Lutte Endometriose, Endofrance, 3 Rue Gare, F-70190 Tresilley, France

[36] Hosp Civils Lyon, Publ Hlth Unit, F-69500 Bron, France

[37] Univ Claude Bernard Lyon 1, Res Healthcare Performance RESHAPE, Inserm, U1290, F-69008 Lyon, France

[38] HES SO Univ Appl Sci & Arts Western Switzerland, Geneva Sch Hlth Sci, CH-1206 Geneva, Switzerland

[39] Univ Paris Saclay, Equipe RISCQ Risques Clin & Securite Sante Femmes, UVSQ, F-78180 Montigny Le Bretonneux, France

[40] Univ Sorbonne Paris Nord, Inst Rech Interdisciplinaire Enjeux Sociaux, UMR 8156 997, UFR SMBH, F-93000 Bobigny, France

[41] Univ Bordeaux, INSERM, Biol Cardiovasc Dis, U1034, Pessac, France

[42] Conseil Dept Val de Marne, Direct Protect Maternelle & Infantile & Promot Sa, F-94000 Creteil, France

[43] Univ Rennes, Irset Inst Rech Sante Environm & Travail, Univ Angers, UMR S1085,CHU Angers,Inserm,EHESP, Angers, France

[44] CHU Rennes, Dept Gynecol & Obstet, F-35000 Rennes, France

[45] Sorbonne Univ, F-75013 Paris, France

[46] Nantes Univ, EA 4334, Lab Mouvement, Interact,Performance MIP, F-44322 Nantes, France

[47] Clin Mathilde, Cabinet Med, F-76100 Rouen, France

[48] Univ Poitiers, Inserm CIC 1402, F-86000 Poitiers, France

[49] Ctr Hosp Lyon Sud, Serv Gynecol Obstet, Pierre Benite, France

来源：

GYNECOLOGIE OBSTETRIQUE FERTILITE & SENOLOGIE | 2023年 / 51卷 / 06期

关键词：

Pelvic exam; Pelvic examination; Speculum examination; Speculum; Gynecological exam; Vaginal speculum; Gynecological examination; Vaginal examination; Physical examination; THREATENED PRETERM LABOR; ASYMPTOMATIC POSTMENOPAUSAL WOMEN; CERVICAL LENGTH MEASUREMENT; RANDOMIZED CONTROLLED-TRIAL; BREAST SELF-EXAMINATION; INTRINSIC SPHINCTER DEFICIENCY; SEXUALLY-TRANSMITTED-DISEASES; INTIMATE PARTNER VIOLENCE; VAGINAL WALL PROLAPSE; Q-TIP TEST;

D O I：

10.1016/j.gofs.2023.04.001

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective. - To provide guidelines for the pelvic clinical exam in gynecology and obstetrics.Material and methods. - A multidisciplinary experts consensus committee of 45 experts was formed, including representatives of patients' associations and users of the health system. The entire guidelines process was conducted independently of any funding. The authors were advised to follow the rules of the Grading of Recommendations Assessment, Development and Evaluation (GRADE & REG;) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized.Methods. - The committee studied 40 questions within 4 fields for symptomatic or asymptomatic women (emergency conditions, gynecological consultation, gynecological diseases, obstetrics, and pregnancy). Each question was formulated in a PICO (Patients, Intervention, Comparison, Outcome) format and the evidence profiles were produced. The literature review and recommendations were made according to the GRADE & REG; methodology.Results. - The experts' synthesis work and the application of the GRADE method resulted in 27 recommendations. Among the formalized recommendations, 17 present a strong agreement, 7 a weak agreement and 3 an expert consensus agreement. Thirteen questions resulted in an absence of recommendation due to lack of evidence in the literature.Conclusions. - The need to perform clinical examination in gynecological and obstetrics patients was specified in 27 pre-defined situations based on scientific evidence. More research is required to investigate the benefit in other cases.& COPY; 2023 Elsevier Masson SAS. All rights reserved.

引用

页码：297 / 330

页数：34

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