{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:41:48Z","timestamp":1787013708249,"version":"build-2736575974"},"reference-count":5,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T00:00:00Z","timestamp":1364774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      The study aims to determine if a vaginal examination improves diagnostic accuracy when assessing women who present to the\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      with vaginal bleeding in the first trimester of pregnancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      One hundred and thirty\u2010five women with first trimester bleeding were randomised to have a vaginal examination (\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">n<\/jats:styled-content>\n                      <\/jats:italic>\n                      = 61) or not (\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">n<\/jats:styled-content>\n                      <\/jats:italic>\n                      = 74). They were given a provisional diagnosis, and then a final diagnosis after ultrasound, beta\u2010human chorionic gonadotropin and gynaecological follow up. The provisional diagnosis was considered accurate if it matched the final diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The provisional and final diagnoses matched in a little over half of the cases, and there was no statistical difference between the two groups (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 0.005,\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\n                      <\/jats:italic>\n                      = 0.94).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In a stable patient presenting to the\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      with first trimester bleeding, clinical diagnosis is highly inaccurate and is not improved by vaginal examination. Routine vaginal examination is not necessary as part of the initial patient assessment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.12068","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T05:42:50Z","timestamp":1364794970000},"page":"219-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Vaginal examination does not improve diagnostic accuracy in early pregnancy bleeding"],"prefix":"10.1111","volume":"25","author":[{"given":"Chris","family":"Johnstone","sequence":"first","affiliation":[{"name":"Emergency Department Caboolture Hospital  Caboolture Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"257","article-title":"Vaginal bleeding in pregnancy: Part I","volume":"31","author":"Arsove PMDF","year":"2010","journal-title":"Emerg. 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