Materials and methods This study was approved by the CEROG (French Ethics Committee for Research in Obstetrics and Gynecology). Study BKM120 design We retrospectively reviewed the medical records of consecutive women who underwent laparoscopy for acute pelvic pain at the gynecologic ED of the Poissy-St Germain Hospital, France, a teaching hospital serving a large population. This historical cohort was studied between January 1, 2004, and December 31, 2006. One resident and one senior gynecologist are available at the gynecologic ED around the clock. In France, women with acute pelvic

pain are evaluated either LEE011 supplier in general EDs, in which case they are then referred to a gynecologic ED, or directly in selleck screening library gynecologic EDs, to which all women have free access. Thus, all patients with suspected

gynecologic emergencies are seen in gynecologic EDs. Study population All patients seen at our gynecologic ED for acute pelvic pain of less than 7 days’ duration and who underwent emergency laparoscopy were included. Exclusion criteria were hemodynamic shock, pregnancy of more than 13 gestational weeks, secondary laparoscopy for ectopic pregnancy initially managed with methotrexate, surgery within the last month, or virgin patients. Among patients who did not undergo emergency laparoscopy, those who were pregnant were followed until a definitive diagnostic was made [12]. In nonpregnant

patients, when the findings of all examinations were thought to be normal and the pain subsided with appropriate analgesia by the end of the visit or hospitalization, a diagnosis of idiopathic acute pelvic pain was made. After discharge, the patients were encouraged to return to our ED in case of pain recurrence. Study protocol In all patients, a nurse performed an initial assessment including measurement Progesterone of vital signs (Heart rate, arterial pressure and temperature), a urine hCG test and a pain intensity measurement using a Numerical Rating Scale (NRS). Then, the obstetrics/gynecology resident on duty performed standardized physical and TVUS examinations. If needed, additional investigations were performed (laboratory tests, complete ultrasound examination by a certified obstetrician/gynecologist, computed tomography). Residents were between their third and eight semester of formation in gynecology and obstetrics and were non titular of ultrasound diploma. The senior gynecologist decided whether to perform emergency laparoscopy based on all the available data.