[Should all women be ordered gynecological examination a few days after delivery?]

The results of a national survey, including all maternity units in Denmark, showed that 43 of 57 units (almost 75%) advocated routine pelvic examination a few days after delivery. Three out of 60 units did not answer the enquete corresponding to a 95% reply rate. Following the same procedure as the main part of delivery units in Denmark, all women confined in Sønderborg Hospital were offered routine pelvic examination four days after birth, however six days after caesarean section. A retrospective survey of the records for all women hospitalised for delivery in Sønderborg Hospital during 16.5.1990-16.11.1990 showed that 550 out of 715 women (77.0%) had been submitted to routine pelvic examination. Twenty one of these (3.8%) were treated according to one of the following abnormalities: atony of the uterus (14), superficial inflammation in caesarean scar of episiotomy (4) or endometritis (3). Based on a critical review of the cases, its concluded that all the treated complications were either insignificant, were treated unnecessarily or should have been diagnosed from the symptoms. As an alternative it is proposed, that routine pelvic examination a few days after birth should be restricted to selected women at risk. Other puerperal women should be observed closely and, depending on relevant symptoms, a pelvic examination should be made. In all cases and according to regulatives of the Danish Health Authorities (Sundhedsstyrelsen) all puerperal women should be offered a final examination by their practitioner eight weeks after birth.