title: Pelvic Examination at the 6-Week Postpartum Visit After Cesarean Birth.
abstract: BACKGROUND
  The objective of this study was to assess the utility of the pelvic examination at the 6-week postpartum visit after cesarean birth.
  
  
  METHODS
  Data were collected from retrospective chart review in an obstetric resident clinic in Detroit, Michigan. Women included were those who had a cesarean birth between January 2012 and June 2014.
  
  
  RESULTS
  Of 388 women who had a cesarean birth, 211 (54.4%) presented for the 6-week postpartum visit and underwent pelvic examination. Of these women, 185 (87.7%) were asymptomatic, and 26 (12.3%) reported vaginal discharge. No other concerns were elicited. Of those with symptoms, 4 (15%) had no finding, 13 (50%) had bacterial vaginosis (BV) alone, 2 (8%) had BV and Candida sp, 2 (8%) had BV and Trichomonas vaginalis, 2 (8%) had T vaginalis alone, and 3 (11%) had Chlamydia trachomatis. One woman with C trachomatis had tested positive during pregnancy and possibly had treatment failure. Of the 185 asymptomatic women, 91 (49%) were deemed to have vaginal discharge on examination and underwent testing for Neisseria gonorrhoeae and C trachomatis; results were negative in all cases.
  
  
  CONCLUSIONS
  In this population, it appears unnecessary to perform routine pelvic examination on asymptomatic women at the 6-week postpartum visit after cesarean birth. When vaginal discharge was noted during pelvic examination of asymptomatic women, no pathology was identified.
authors.forename: Arnold M
authors.initials: AM
authors.lastname: Mahesan
authors.forename: David M
authors.initials: DM
authors.lastname: Ilceski
authors.forename: Anthea B M
authors.initials: AB
authors.lastname: Paul
authors.forename: Shyla
authors.initials: S
authors.lastname: Vengalil
mesh_terms: D000328:Adult; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis*; D002585:Cesarean Section; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D058869:Gynecological Examination; D006801:Humans; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D011645:Puerperal Infection / Q000175:diagnosis*; D012189:Retrospective Studies; D014247:Trichomonas Vaginitis / Q000175:diagnosis; D019522:Vaginal Discharge / Q000382:microbiology; D014627:Vaginitis / Q000175:diagnosis*; D016585:Vaginosis, Bacterial / Q000175:diagnosis
keywords: 6-week postpartum visit; cesarean section, occult pelvic infection, pelvic examination, pelvic infection, postpartum