Is bedside ultrasound now a routine part of specialist obstetrics and gynaecology outpatient consultation?

Introduction: Portable ultrasound is extensively used in the delivery suite, and there is anecdotal evidence that ultrasound is increasingly common in routine outpatient gynaecological practice. We could find no published data regarding the prevalence of 'rooms' ultrasound use in outpatient gynaecology. Methods: A survey instrument was developed containing demographic questions about 'rooms' ultrasound use, and three clinical vignettes regarding dysmenorrhoea in a young woman, bleeding in early pregnancy, and postmenopausal bleeding. For each vignette, respondents were asked whether they would refer for 'formal' ultrasound or rely on their own findings. The anonymous questions were sent to every obstetrician/gynaecologist in private practice in Australia. Results: 438 surveys were posted and 242 returned (response rate 55%). 226 respondents (93.8%) reported using ultrasound in their consulting rooms, with 201 (88.9%) using transvaginal ultrasound. For the dysmenorrhoea vignette, 59% of respondents would rely on their own ultrasound findings and not refer for additional imaging. For the bleeding in early pregnancy vignette, 91% would rely on their own ultrasound findings and not refer for additional imaging. For post-menopausal bleeding, 54% would rely on their own clinical and ultrasound findings and would not refer for additional imaging. Conclusion: The majority of practitioners would not refer for tertiary ultrasound if their own imaging revealed apparent normal findings.