Emergency Department Patient Perceptions of Transvaginal Ultrasound for Complications of First‐Trimester Pregnancy

• Published in: Journal of ultrasound in medicine 2018-08, Vol.37 (8), p.1965-1975
• Main Authors: Panebianco, Nova, Shofer, Frances, O'Conor, Katie, Wihbey, Tristan, Mulugeta, Lakeisha, Baston, Cameron M, Suzuki, Evan, Alghamdi, Adel, Dean, Anthony
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; emergency medicine; Emergency Service, Hospital; Female; Humans; obstetrics; Patient Satisfaction - statistics & numerical data; patient‐centered care; point‐of‐care ultrasound; practice administration; Pregnancy; Pregnancy Complications - diagnostic imaging; Pregnancy Trimester, First; Prospective Studies; sonographer issues; transvaginal ultrasound education; Ultrasonography, Prenatal - methods; Vagina - diagnostic imaging; Young Adult
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.14546

Objectives Emergency department (ED) transvaginal ultrasound (US) is underused in clinical practice. This study assessed pregnant women's perceptions of ED transvaginal US in terms of pain, embarrassment, anxiety, and willingness to receive the procedure. Secondary variables include physicians' perceptions of patients' experiences. Methods Women undergoing US examinations for complications of first‐trimester pregnancy were prospectively surveyed before any US and after ED and/or radiology transvaginal US. Patients' and physicians' assessments of pain, embarrassment, and anxiety were measured with visual analog scales (0–100). Results A total of 398 women were enrolled. In the pre‐US survey, the median anxiety score was 14 (interquartile range, 3–51), and 96% of patients were willing to have an ED transvaginal US if necessary. Of those who had ED transvaginal US, 96% would agree to have another examination. Patients reported minimal pain/embarrassment, and there was no difference if performed in the ED versus radiology (median pain, 11.5 versus 13; P = .433; median embarrassment, 7 versus 4; P = .345). Of the 48 who had both ED and radiology transvaginal US, 85% thought the ED transvaginal US was worthwhile. Physicians accurately assessed patient's embarrassment and pain (mean differences, 3.5 and –1.9, respectively; P > .25 for both); however, they overestimated them relative to the pelvic examination (mean difference for embarrassment, 12.8; P