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. 2023 Dec;63(6):803-810.
doi: 10.1111/ajo.13733. Epub 2023 Jul 10.

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

Baylie Trostian  1   2   3 , Andrea McCloughen  1 , Judith Fethney  1 , Kate Curtis  1   2   3
Affiliations

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

Baylie Trostian et al. Aust N Z J Obstet Gynaecol. 2023 Dec.

Abstract

Background: Women present to the emergency department (ED) with pregnancy complications including bleeding. They seek investigations, treatment and clear discharge and referral pathways.

Aims: The aim was to identify trends, characteristics, ED care and discharge pathways for women who present to the ED with early pregnancy bleeding.

Methods: Retrospective 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.

Results: Over 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.

Conclusions: Maternal 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.

Keywords: bleeding; early pregnancy; emergency department; nursing; pregnancy complication.

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