Manual Uterine Aspiration in the Emergency Department as a First-Line Therapy for Early Pregnancy Loss: A Single-Centre Retrospective Study

Whittaker, Lauren; Pymar, Helen; Liu, Xiaoqing

doi:10.1016/j.jogc.2022.02.009

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…41 This could include skills such as control of uterine hemorrhage, which are well within the competencies of EM physicians. Training EM physicians in procedures such as IUD insertion for emergency contraception, manual uterine aspiration, 42 medication abortion, and medication for management of miscarriage may be considered depending on the practice setting, geographic location, and local needs of the patient population. 41 Finally, the Model of Clinical Practice of Emergency Medicine (EM Model), which serves as the basis for content for the American Board of Emergency Medicine (ABEM) examinations, is reviewed and updated by an ABEM task force every 3 years.…”

Section: Anticipated Impact On Em Education and Trainingmentioning

confidence: 99%

“…This could include skills such as control of uterine hemorrhage, which are well within the competencies of EM physicians. Training EM physicians in procedures such as IUD insertion for emergency contraception, manual uterine aspiration, 42 medication abortion, and medication for management of miscarriage may be considered depending on the practice setting, geographic location, and local needs of the patient population 41 …”

Section: Introductionmentioning

confidence: 99%

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Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Samuels‐Kalow

Agrawal

Rodriguez

et al. 2022

Academic Emergency Medicine

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On June 24, 2022, the United States Supreme Court ruled on Dobbs v. Jackson Women's Health Organization and overturned Roe v. Wade, removing almost 50 years of precedent and allowed individual states to determine restrictions on abortion. While the state-level policy landscape remains fluid, the Guttmacher Institute reports that 26 states (half of the United States) are likely to ban access to abortion, if their trigger laws have not already done so, 1 with critical implications for pregnant patients, those with reproductive potential, and the clinicians who care for them.The emergency department (ED) is an important access point for reproductive healthcare. More than 900,000 ED visits each year are for early pregnancy loss, which does not include those presenting for

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Section: Anticipated Impact On Em Education and Trainingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Samuels‐Kalow

Agrawal

Rodriguez

et al. 2022

Academic Emergency Medicine

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“…Promotion of MVA for management of EPL in the emergency department among trained emergency physicians is increasing, particularly for use in rural or remote communities where procedural management is indicated but would require transfer and delays in care [9]. Whittaker et al [10 ▪▪ ] demonstrated lower complication rates with emergency department-based MVA compared with other management options (expectant management, medication, and electric vacuum aspiration outside of the emergency department). Importantly, the total time in the emergency department was clinically and statistically similar for all of these management options.…”

Section: Miscarriage Managementmentioning

confidence: 99%

The evolving role of emergency medicine in family planning services

Preiksaitis,

Henkel

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review The emergency department serves as an essential access point for a variety of healthcare services. This review will examine the recent expansion of family planning and reproductive health services in the emergency department. Recent findings An increasing number of patients present to emergency departments for early pregnancy loss (EPL), abortion care, and contraceptive management. Availability of comprehensive EPL management varies dramatically, possibly due to lack of provider knowledge or training. Particularly in remote settings, educational interventions – such as providing information about medication management and training in uterine aspiration – may standardize this management. Restrictive abortion laws raise concerns for changing and increased patient presentations to the emergency department for complications related to unsafe or self-managed abortion. Emergency medicine providers should anticipate that more patients will present without a prior ultrasound confirming intrauterine pregnancy prior to initiating no-touch or self-managed abortions. Particularly among pediatric patients, there may be a role for contraceptive counseling during an emergency department visit. Novel strategies, including web-based interventions and emergency department-based curricula for contraceptive counseling, may help reach those who otherwise may not seek reproductive healthcare in a clinic setting. Summary The intersection of emergency medicine and reproductive healthcare is a promising frontier for providing immediate, patient-centered, family planning care. Continued research and provider education are necessary to refine these approaches, address disparities, and respond to the changing reproductive healthcare landscape.

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“…Many patients choose this option when available for convenience and ease of scheduling because coordination with the operating room is not required. 14 Overall, serious complications are rare following early pregnancy loss treatment. Hemorrhage and infection can occur with all treatment modalities.…”

Section: Early Pregnancy Lossmentioning

confidence: 99%