Guidelines for the Well-Woman Exam - CME Conferences
Guidelines for the Well-Woman Exam - CME Conferences Guidelines for the Well-Woman Exam - CME Conferences
2 nd Annual Primary Care Fall Conference Wednesday, October 24, 2012For STI Screening• Amplified DNA technology permitstesting on a urine or vaginal swabspecimen NO pelvic / cervical exam required(except to evaluate for “PID” )For PrescribingContraceptionACOG Recommendations• “A pelvic examination is notrequired in order to prescribehormonal contraception”• Felicia Stewart Clinical Breast and PelvicExamination Requirements: Current Practice vs.Evidence JAMA 2001; 285: 2232-9David Plourd, MDWomen Exam
2 nd Annual Primary Care Fall Conference Wednesday, October 24, 2012Pelvic Examination• Vaginal Speculum Not evidence based Not required after Hyst & BSO for B9dzz (still examine external genitalia);nor is bimanual required in thissettingPelvic Examination• Bimanual ACOG recomm: @13-20 y/o -ONLY do it as indicated (e.g.AUB, amenorrhea, STD, mass, discharge);becomes routine Annually as of age 21 (no evidence tosupport or refute benefits – for low-risk pt.) After Hyst & BSO for B9 dzz (still examineexternal genitalia) – no longer required ref: ACOG Comm. Opinion #534, Aug, 2012) USPSTF states that there is insufficientevidence to argue for or against bimanualexam in a’sx’tic women at increased riskfor ovarian cancerDavid Plourd, MDWomen Exam
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2 nd Annual Primary Care Fall Conference Wednesday, October 24, 2012For STI Screening• Amplified DNA technology permitstesting on a urine or vaginal swabspecimen NO pelvic / cervical exam required(except to evaluate <strong>for</strong> “PID” )For PrescribingContraceptionACOG Recommendations• “A pelvic examination is notrequired in order to prescribehormonal contraception”• Felicia Stewart Clinical Breast and Pelvic<strong>Exam</strong>ination Requirements: Current Practice vs.Evidence JAMA 2001; 285: 2232-9David Plourd, MDWomen <strong>Exam</strong>
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