Pregnant and Bleeding: Assessing Factors Associated with Emergency Care in Early Pregnancy

The majority of patients who present to the Emergency Department with bleeding or pain during pregnancy are low acuity. A recent study featuring PISC Executive Committee Member Zachary Meisel, MD, MPH, MA, assesses the prevalence of critical pregnant patients in the ED, and evaluates common characteristics of patients who require emergency care. 484 pregnant patients who presented to 3 EDs were included in the study. Patients completed a questionnaire to identify baseline clinical variables. Results indicate that only 4.3% of patients were classified as Critical. Risk factors included a prior history of ectopic pregnancy, heavy bleeding for the past two hours, or having made a prior-pregnancy related visit to the ED. Additionally, no demographic characteristics were discerned among Critical and Low-Acuity patients. In the future, creating a refined process to define and treat low-acuity versus high-acuity pregnancy concerns can both improve ED efficiency and improve patient experience within the ED.

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