Clinical Policy: Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy

Hahn, Sigrid A.; Mace, Sharon E.; Napoli, Anthony M.; Fesmire, Francis M.

doi:10.1016/j.annemergmed.2016.11.002

Cited by 30 publications

(2 citation statements)

References 37 publications

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“…This finding implies that some return visits may have been planned for investigations. Guidelines suggest that an ultrasound can be delayed for clinically stable patients informed by clinical judgement and joint decision making 21,22 …”

Section: Discussionmentioning

confidence: 99%

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Presentation trends, characteristics and outcomes for women with early pregnancy bleeding in the emergency department: A 10‐year data linkage study

Trostian

McCloughen

Fethney

et al. 2023

Aust NZ J Obst Gynaeco

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BackgroundWomen present to the emergency department (ED) with pregnancy complications including bleeding. They seek investigations, treatment and clear discharge and referral pathways.AimsThe aim was to identify trends, characteristics, ED care and discharge pathways for women who present to the ED with early pregnancy bleeding.MethodsRetrospective data (from 2011 to 2020) were extracted from a regional health district‘s databank. Data were processed, and deterministic linking was used to produce a final data set. Descriptive statistics were used to identify trends and characteristics. Linear and logistic regression models were used to identify factors that influence health service use, outcomes and discharge pathways.ResultsOver the 10 years, there have been almost 15 000 presentations to the ED for early pregnancy bleeding, from approximately 10 000 women, 0.97% of all ED presentations. The frequency of presentations increased by 19.6% over the study period. The average age of women who presented to the ED was 29.1 years, which increased from 28.5 years (2011) to 29.3 (2020). The median length of stay was less than 4 h, and most women were treated and discharged from the ED. One‐third of presentations received neither ultrasound nor pathology, but health service costs increased by 330% from 2014 to 2020.ConclusionsMaternal age is increasing, as is the frequency of ED presentations for early pregnancy bleeding, and both factors increase demands on the ED. Findings from this study may inform strategies to improve current care models and improve quality and safety practices within the ED.

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Section: Discussionmentioning

confidence: 99%

“…Guidelines suggest that an ultrasound can be delayed for clinically stable patients informed by clinical judgement and joint decision making. 21,22…”

Section: Return Visitsmentioning

confidence: 99%