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P067: Ectopic pregnancy outcomes in patients discharged from the emergency department

Published online by Cambridge University Press:  11 May 2018

K. Hawrylyshyn*
Affiliation:
Schwartz/Reisman Emergency Medicine Institute, Toronto, ON
S. McLeod
Affiliation:
Schwartz/Reisman Emergency Medicine Institute, Toronto, ON
J. Thomas
Affiliation:
Schwartz/Reisman Emergency Medicine Institute, Toronto, ON
C. Varner
Affiliation:
Schwartz/Reisman Emergency Medicine Institute, Toronto, ON
*
*Corresponding author

Abstract

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Introduction: The objective of this study was to determine the proportion of women who had a ruptured ectopic pregnancy after being discharged from the ED where ectopic pregnancy had not yet been excluded. Methods: This was a retrospective chart review of pregnant (<12 week gestational age) women discharged home from an academic tertiary care ED with a diagnosis of ectopic pregnancy, rule out ectopic pregnancy, or pregnancy of unknown location (PUL) over a 7 year period. Results: Of the 550 included patients, 83 (15.1%) had a viable pregnancy, 94 (17.1%) had a spontaneous or missed abortion, 230 (41.8%) had an ectopic pregnancy, 72 (13.1%) had unknown outcomes and 71 (12.9%) had other outcomes which included therapeutic abortion, molar pregnancy or resolution of HCG with no location documented. Of the 230 ectopic pregnancies, 42 (7.6%) underwent expectant management, 131 (23.8%) were managed medically with methotrexate, 29 (5.3%) were managed with surgical intervention, and 28 (5.1%) patients had a ruptured ectopic pregnancy after their index ED visit. Of the 550 included patients, 221 (40.2%) did not have a transvaginal US during their index ED visit, 73 (33.0%) were subsequently diagnosed with an ectopic pregnancy. Conclusion: These results may be useful for ED physicians counselling women with symptomatic early pregnancies about the risk of ectopic pregnancy after they are discharged from the ED.

Type
Poster Presentations
Copyright
Copyright © Canadian Association of Emergency Physicians 2018