Slide1 l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 13

Introduction PowerPoint PPT Presentation


  • 64 Views
  • Uploaded on
  • Presentation posted in: General

Introduction. 600,000 hysterectomies per year Modes of hysterectomy include trans-abdominal, trans-vaginal, laparoscopic assisted, and total laparoscopic. Modes of assessment. Bimanual exam Ultrasound.

Download Presentation

Introduction

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Introduction l.jpg

Introduction

  • 600,000 hysterectomies per year

  • Modes of hysterectomy include trans-abdominal, trans-vaginal, laparoscopic assisted, and total laparoscopic


Modes of assessment l.jpg

Modes of assessment

  • Bimanual exam

  • Ultrasound


Slide4 l.jpg

  • Objectives: to determine how accurate both bimanual exams and ultrasound exams are in determining estimated uterine weight

  • Study Design: retrospective chart review performed at Texas Tech University Health Sciences Center and the affiliated hospital, University Medical Center


Materials and methods l.jpg

Materials and Methods

  • Chart review from the year 2003- 2007

  • Information retrieved

    • Estimated uterine size by physical exam

    • Pelvic ultrasound measurements

    • Actual uterine weight from pathology reports

    • Height and weight to calculate BMI

  • Statistics used: linear regression analysis


Slide6 l.jpg

388 hysterectomies that met the inclusion criteria

6 charts with no documented pathology weight

366 charts reviewed

22 charts not accessible

185 charts with documented bimanual estimation of uterine size

129 charts with pelvic ultrasound performed no more than three month prior to surgery


Texas tech chart l.jpg

Texas Tech Chart


Preoperative clinical uterine size along with mean uterine weights of specimens l.jpg

Preoperative clinical uterine size along with mean uterine weights of specimens

  • nongravid ut size(wk) mean ut weight(g) stand deviation(g)

    6 113 +/-48

    8 141 +/-66

    10 172 +/-82

    12 233 +/-113

    14 321 +/-160

    16 465 +/-209

    18 747 +/-311

    20 1046 +/-464

    22 1246 +/-588

    24 1459 +/-479

    26 1730 +/-713

    *Harb and Adam


Clinical exam compared to actual weights l.jpg

Clinical exam compared to actual weights


Ultrasound compared to actual weights l.jpg

Ultrasound compared to actual weights


Results by linear regression analysis l.jpg

Results by Linear Regression Analysis

  • Statistical analysis indicated R squared of 0.9773 when comparing the bimanual method to the pathological weight and R squared of 0.8033 when comparing the Ultrasound method to the pathological weight

  • The statistical analysis indicated R squared of 0.9032 when comparing obese subjects and R squared of 0.7833 in the non-obese subjects


Conclusion l.jpg

Conclusion

  • Bimanual exam was more accurate at predicting uterine weights compared to pelvic ultrasound, although this was not statistically significant

  • BMI did not influence the accuracy in estimating uterine size on bimanual exams

  • The objectives were met as shown by the above stated results. For purposes of estimating uterine size prior to hysterectomy bimanual examination highly correlates with actual uterine size. These results do not support pelvic ultrasound as a preferred method for purposes of estimating uterine size


References l.jpg

References

  • Cantuaria GH, Angioli R, Forst L, Duncan R, Penalver MA. Comparison of bimanual examination with ultrasound examination before hysterectomy for uterine leiomyoma. Obstet Gynecol 1998;92:109-12.

  • Flikinger L, D’Ablaing GD, Mishell, DR. Size and weight determinations of nongravid enlarged uteri. Obstet Gynecol 1986;68: 855-8.

  • Harb T, Adam R. Predicting uterine weight before hysterectomy: Ultrasound measurements versus clinical assessment. Am J Obstet Gynecol 2005;193: 2122-5.

  • Kung FT, Chang SY. The relationship between ultrasonic volume and actual weight of pathologic uterus. Gynecol Obstet Invest 1998;42: 35-8.


  • Login