TA and EV Pelvis Curriculum

US didactics:

Week 1 –  TA / EV Pelvic US and Regional Anatomy  –

Week 2-  TA /EV Pelvic US in Pregnancy (FHR, CRL & NDIUP/LIUP/IUP/Abnormal IUP) –

Week 3-  TA / EV Pelvis US – Ectopic Pregnancy-

Week 4 –  TA /EV Pelvis US for the Non-Pregnant Patient – Cysts/masses/torsion –

Week 5 – Case based presentations by Faculty, Fellows present and review Pelvic Studies –

Reading/Review List:

SonoGuide: Pelvic US in pregnancy

SonoSpot: TutorialCasesStudiesTips & Tricks

Podcasts: Soundbytes: Pelvic US

AIUM Practice Guidelines: Obstetric and Pelvic

AIUM UltrasoundFirst Series: Sonography in Post menopausal Bleeding and Sonographic Evaluation of Acute Pelvic Pain


Ma/Mateer/Blaivas Chapters:

12. First Trimester Pregnancy, Robert F. Reardon and Scott A. Joing
13. Second- and Third-Trimester Pregnancy, Bradley W. Frazee and Chandra Aubin
14. Gynecologic Concepts, J. Christian Fox and Michael J. Lambert


Dawson/Mallin iBook Chapters:

Volume 1, Chapter 7 – Pregnancy

Pelvic Studies Ectopic:  PubMed Collection

Pelvic Studies Ovarian Torsion: PubMed Collection

Transvaginal Ultrasound and HPV exposure: http://www.medscape.com/viewarticle/805029?src=journalnl&uac=120316PJ

Pelvic US for the Pregnant Patient Studies:

Shih CHY.  Effect of emergency-physician performed pelvic sonography on length of stay in the emergency department.  Ann Emer Med 1997; 29(3):348-352.

Burgher SW, Tandy TK, et al.  Transvaginal ultrasonography by emergency physicians decreases patient time in the emergency department.  Acad Emer Med1998; 5:802-807.

Dart RG, Dart L, et al.  The predictive value of endometrial stripe thickness in patients with suspected ectopic pregnancy who have an empty uterus at ultrasonography.  Acad Emer Med1999; 6(6):602-608.

Blaivas M, Sierzenski P, et al.  Do emergency physicians save time when locating a live intrauterine pregnancy with bedside ultrasonography?  Acad Emer Med 2000; 7(9):988-993.

Rodgerson JD, Heegaard WG, et al.  Emergency department right upper quadrant ultrasound is associated with reduced time to diagnosis and treatment of ruptured ectopic pregnancies.  Acad Emer Med 2001; 8(4):331-336.

Tayal VS, Cohen H, et al.  Outcome of patients with an indeterminant emergency department first-trimester pelvic ultrasound to rule out ectopic pregnancy.  Acad Emer Med 2004; 11(9):912-917.

Adhikari S, Blaivas M, et al.  Diagnosis and management of ectopic pregnancy using bedside transvaginal ultrasonography in the ED: a 2-year experience.  Amer J Emer Med 2007; 25:591-596

Dart, R.G., B. Kaplan & K. Varaklis. (1999). Predictive value of history and physical examination in patients with suspected ectopic pregnancy. Annals of Emergency Medicine 33, 283-290.

Durham, B., B. Lane, L. Burbridge & S. Balasubramaniam.(1997). Pelvic ultrasound performed by emergency physicians for the detection of ectopic pregnancy in complicated first-trimester pregnancies. Annals of Emergency Medicine 29, 338-347.

Mateer, J.R., E.J. Aiman, M.H. Brown & D.W. Olson. (1995). Ultrasonographic examination by emergency physicians of patients at risk for ectopic pregnancy.Academic Emergency Medicine :2, 867-873.

Mateer, J.R., V.T. Valley, E.J. Aiman, M.B. Phelan, M.E. Thoma& M.P. Kefer. (1996). Outcome analysis of a protocol including bedside endovaginal sonography in patients at risk for ectopic pregnancy. Annals of Emergency Medicine 27, 283-289.

McRae, A., H. Murray & M. Edmonds. (2009). Diagnostic accuracy and clinical utility of emergency department targeted ultrasonography in the evaluation of first-trimester pelvic pain and bleeding: a systematic review. Cjem 11, 355-364.

Moore, C., W.M. Todd, E. O’Brien & H. Lin. (2007). Free fluid in Morison’s pouch on bedside ultrasound predicts need for operative intervention in suspected ectopic pregnancy. Academic Emergency Medicine 14, 755-758.

Stovall TG, Kellerman AL, Ling FW, Buster JE. Emergency department diagnosis of ectopic pregnancy. Ann Emerg Med.1990;19(10):1098-1103.

Kaplan BC, Dart RG, Moskos M, Kuligowska E, Chun B, Adel Hamid M, Northern K, Schmidt J, Karwadkar A. Ectopic pregnancy: Prospective study with improved diagnostic accuracy. Ann Emerg Med.1996;28:10-17.

Buckley RG, King KJ, Disney JD, Gorman JD, Klausen JH. History and physical examination to estimate the risk of ectopic pregnancy: Validation of a clinical prediction model. Ann Emerg Med.1999;34:589-594.

Barnhart K, Mennuti MT, Benjamin I, Jacobson S, Goodman D, Coutifaris C. Prompt diagnosis of ectopic pregnancy in an ED setting. Obstet Gynecol.1994;84(6):1010-15.

Kaplan BC, Dart RG, Moskos M, Kuligowska E, Chun B, Adel Hamid M, Northern K, Schmidt J, Kharwadkar A. Ectopic pregnancy: Prospective study with improved diagnostic accuracy. Ann Emerg Med.1996;28:10-17.

Gracia CR, Barnhart KT. Diagnosing ectopic pregnancy: Decision analysis comparing six strategies. Obstet Gynecol.2001;97:464-70.

Dogra V, Paspulati RM, Bhatt S. First Trimester Bleeding Evaluation. Ultrasound Quarterly 2005; 21:69-85.

Kirk E, Bourne T. Diagnosis of ectopic pregnancy. Best Practice & Research Clinical Obstetrics and Gynaecology. 2009 (23): 501-508.

Kirk E, Daemen A, Papageorghiou AT, Bottomley C, Condous G, De Moor B, Timmerman D, Bourne T.   Why are some ectopic pregnancies characterized as pregnancies of unknown location at the initial transvaginal ultrasound examination? Acta Obstet Gynecol Scand 2008;87(11):1150-54.

Gurel S, Sarikaya B, Gurel K, Akata D. Role of sonography in the diagnosis of ectopic pregnancy.  J of Clinical Ultrasound. 2007 35:509-517.

Timor-Tritsch IE, Rottem S. Transvaginal ultrasonographic study of the fallopian tube.  Obstet. Gynecol. 1987 (70): 424-28.

Blaivas M, Lyon M. Reliability of adnexal mass mobility in distinguishing possible ectopic pregnancy from corpus luteum cysts.  J Ultrasound Med 2005; 24:599-603.

Frates MC, Laing FC.  Sonographic evaluation of ectopic pregnancy: an update.   Am J Roentgenol 1995; 165: 251-259.

Frates MC, Visweswaran A,  Laing FC. Comparison of tubal ring and corpus luteal echogenicities: a useful differentiating characteristic. J Ultrasound Med 2001; 20: 27-31.

Stein MW, Ricci ZJ, Novak L, Roberts JH, Koenigsberg M. Sonographic comparison of the tubal ring of ectopic pregnancy with the corpus luteum.  J Ultarsound Med 2004, 23: 57-62.

Blaivas M.  Color Doppler in the diagnosis of ectopic pregnancy in the emergency department: Is there anything beyond a mass and fluid? J Emerg Med.2002;22(4):379-384.

R, McLean S, Dart L. Isolated fluid in the cul-de-sac: How well does it predict ectopic pregnancy?  Am J Emerg Med.2002; 20:1-4.

Bhatt S, Ghazale H, Dogra VS. Sonographic evaluation of ectopic pregnancy.  Radiol Clin N Am 45(2007): 549-560.

Ackerman TE, Levi CS, Dashefsky SM, Holt SC, Lindsay DJ. Interstitial line: Sonographic finding in interstitial (cornual) ectopic pregnancy.  Radiology 1993; 189:83-7.

Benson CB, Doubilet PM. Strategies for conservative treatment of cervical ectopic pregnancy. Ultrasound Obstet. Gynecol. 8(1996); 371-2.

Jurkovic D, Hacket E, Campbell S. Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively.  Ultrasound Obstet. Gynecol. 8(1996); 373-380.

Goldman GA, Fisch B, Ovadia J, Tadir Y. Heterotopic pregnancy after assisted reproductive technologies.  Obstetrical and Gynecological Survey1992(47): 217-220.

Kirk E, Condous G, Bourne T. Pregnancies of unknown location.  Best Practice & Research Clinical Obstetrics and Gynecology. 2009. 23; 493-499.

Condous G, Kirk E, Lu C, Gevaert O, De Moor B, De Smet F, Timmerman D, Bourne T. Diagnostic accuracy of the discriminatory zones for the prediction of ectopic pregnancy in women with a pregnancy of unknown location.  Ultrasound Obstet Gynecology. 2005(26):770-775.

Seeber BE, Sammel  MD, Guo W, Zhou L, Hummel A, Barnhart K. Application of redefined human chorionic gonadotropin curves for the diagnosis of woman at risk for ectopic pregnancy. Fertil Steril 2006. 86; 454-9.

Barnhart KT, Sammel MD, Rinaudo PF, Zhou L, Hummel AC, Guo W.  Symptomatic patients with an early.  intrauterine pregnancy: HCG curves redefined. Obstet Gynecol 2004(104): 50-55.

Wang R, Reynolds TA, West HH, Ravikumar D, Martinez C, McAlpine I, Jacoby VL, Stein JC Use of a β-hCG discriminatory zone with bedside pelvic ultrasonography. Ann Emerg Med. 2011 Jul;58(1):12-20. doi: 10.1016/j.annemergmed.2010.12.023. Epub 2011 Feb 18.

Jang TB, Ruggeri W, Dyne P, Kaji AH Learning curve of emergency physicians using emergency bedside sonography for symptomatic first-trimester pregnancy.Ultrasound Med. 2010 Oct;29(10):1423-8.

 Stein JC, Wang R, Adler N, Boscardin J, Jacoby VL, Won G, Goldstein R, Kohn MA. Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis. Ann Emerg Med. 2010 Dec;56(6):674-83. doi: 10.1016/j.annemergmed.2010.06.563. Epub 2010 Sep 15

Stone MB Emergency ultrasound diagnosis of ruptured ectopic pregnancy. Acad Emerg Med. 2009 Dec;16(12):1378. doi: 10.1111/j.1553-2712.2009.00538.x. Epub 2009 Nov 16.

Doane B, Perera P. Emergency ultrasound identification of a cornual ectopic pregnancy. West J Emerg Med. 2012 Sep;13(4):315. doi: 10.5811/westjem.2011.10.6912.

Peter M. Doubilet, M.D., Ph.D., Carol B. Benson, M.D., Tom Bourne, M.B., B.S., Ph.D., and Michael Blaivas, M.D. for the Society of Radiologists in Ultrasound Multispecialty Panel on Early First Trimester Diagnosis of Miscarriage and Exclusion of a Viable Intrauterine Pregnancy. Diagnostic Criteria for Nonviable Pregnancy Early in the First Trimester. N Engl J Med 2013; 369:1443-1451October 10, 2013DOI: 10.1056/NEJMra1302417

Pelvic for the non-pregnant Studies

Poonai N, Poonai C, Lim R, Lynch T.Pediatric ovarian torsion: case series and review of the literature. Can J Surg. 2013 Apr;56(2):103-8. doi: 10.1503/cjs.013311.

Valentin L. Characterising acute gynaecological pathology with ultrasound: an overview and case examples. Best Pract Res Clin Obstet Gynaecol. 2009 Oct;23(5):577-93. doi: 10.1016/j.bpobgyn.2009.02.005. Epub 2009 Apr 28. Review.

Frasure SE, Rempell JS, Noble VE, Liteplo AS. Emergency ultrasound diagnosis of ovarian hyperstimulation syndrome: case report.J Emerg Med. 2012 Aug;43(2):e129-32. doi: 10.1016/j.jemermed.2011.06.148. Epub 2012 Apr 21

Wilkinson C, Sanderson A. Adnexal torsion — a multimodality imaging review. Clin Radiol. 2012 May;67(5):476-83. doi: 10.1016/j.crad.2011.10.018. Epub 2011 Dec 3. Review.

Villalba ML, Huynh B, So M, Mackenzie JD, Ledbetter S, Rybicki F. An ovary with a twist: a case of interesting sonographic findings of ovarian torsion. J Emerg Med. 2005 Nov;29(4):443-6.

Tayal VS, Bullard M, Swanson DR, Schulz CJ, Bacalis KN, Bliss SA, Norton HJ. ED endovaginal pelvic ultrasound in nonpregnant women with right lower quadrant pain. Am J Emerg Med. 2008 Jan;26(1):81-5.

Tayal VS, Crean CA, Norton HJ, Schulz CJ, Bacalis KN, Bliss S  Prospective comparative trial of endovaginal sonographic bimanual examination versus traditional digital bimanual examination in nonpregnant women with lower abdominal pain with regard to body mass index classification. J Ultrasound Med. 2008 Aug;27(8):1171-7.

Weaver J, McHugo JM, Clark TJ. Accuracy of transvaginal ultrasound in diagnosing endometrial pathology in women with post-menopausal bleeding on tamoxifen.Br J Radiol. 2005 May;78(929):394-7.

Lewiss RE, Saul T, Goldflam K.Sonographic cervical motion tenderness: A sign found in a patient with pelvic inflammatory disease. Crit Ultrasound J. 2012 Sep 18;4(1):20. doi: 10.1186/2036-7902-4-20

Adhikari S, Blaivas M, Lyon M. Role of bedside transvaginal ultrasonography in the diagnosis of tubo-ovarian abscess in theemergency department. J Emerg Med. 2008 May;34(4):429-33. doi: 10.1016/j.jemermed.2007.05.057. Epub 2008 Feb 1.

Lambert MJ, Villa M. Gynecologic ultrasound in emergency medicine. Emerg Med Clin North Am. 2004 Aug;22(3):683-96. Review

Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med. 2011 Sep;30(9):1205-10.

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