Use of ultrasound in the setting of a sexual health clinic
A. Brockmeyer, and A. Webb
Abacus Clinics, Liverpool, UK
Background Ultrasound scans (USS) are frequently performed in hospital or outpatient
gynaecology in the UK. So far, the use of USS in the community setting of sexual
and reproductive health has not been established. Reasons for this are the
uncertainty of indications, unavailability of ultrasound scanners, lack of
experienced sonographers and the need to maintain clinical governance. The
service in Liverpool has an ultrasound scanner at its main clinic, Central
Abacus (CA). The clinical protocols identify two indications for the use of USS:
determination of gestation prior to referral for abortion where gestation is
uncertain and location of an IUD/IUS. Objectives
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To analyse indications for
USS performed at CA and to determine if they adhere to those in the clinical
protocols.
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To establish the role of USS in the community setting of sexual
& reproductive health and how this role could be extended further.
Methods
Retrospective audit. Computerised records were analysed to determine the number
of USS performed at CA. Client’s records were reviewed to find out the
indications for USS and the outcomes. These were then compared with the
standards set in the clinical protocols.
Results The computer identified 71
women who had an USS between 1/1/04 and 31/0/04. The records of 60 women were
reviewed in detail. The review of these notes revealed that 56 women had an USS
at CA. Six doctors performed between 2 and 12 USS in three months. 66% of women
had an USS to check gestation prior to referral for abortion; 27% for location
of an IUD. In most cases of other indications this was related to IUD fittings
or complications during pregnancy. In about 40% of women having an USS helped to
decide about the referral to the appropriate abortion provider. As a result of
the audit, the wording of the USS standards has been refined.
Conclusions USS
can be useful in the setting of a sexual health clinic. To ensure clinical
governance indications must be clearly defined due to relatively small numbers
of USS and variable scanning experience. The use of USS could be extended if
more clinicians were available for scanning and if there was standardised USS
training available.