The Semi-Sitting Position for Pelvic Examination

To the Editor.— Textbooks in obstetrics and gynecology routinely advocate the supine lithotomy position for pelvic examination. A study was designed to examine the degree to which the semi-sitting position (Figure) might influence relaxation of the abdominal muscles—and, therefore, the ease of palpation of the pelvic organs—and the degree of patient comfort during pelvic examination. The study was conducted at the Outpatient Clinics of the Universityof California, San Diego Medical Center. Eight examiners, four male, four female, with little or no prior experience with the semi-sitting position for pelvic examination, participated in the study. All patients to have a pelvic examination by one of the eight examiners had the bimanual portion of the pelvic examination performed in both the supine and the semisitting positions. Patients were randomized as to whether the supine or the semi-sitting examination was performed first,