Is routine antenatal booking vaginal examination necessary for reasons other than cervical cytology if ultrasound examination is planned?

Sixteen ovarian cysts, including one borderline ovarian malignancy, and ten trichomonal vaginal discharges but no cases of cervical incompetence or ectopic pregnancy had been detected at booking vaginal examination in 11,622 consecutive antenatal case records abstracted retrospectively. In an attitude survey of pregnant women 77% believed that vaginal examination was reassuring, 55% found it unpleasant, and 18% thought it could cause miscarriage. This, and a review of the literature, suggests that routine vaginal examination if ultrasound is planned has few advantages beyond the taking of a cervical smear.