Twenty percent of clinically recognized pregnancies result in early pregnancy loss (EPL). One of the most common symptoms of EPL, vaginal bleeding in pregnancy, accounts for 2% of all visits to the emergency department (ED) every year. Treatment options that can be offered to patients in the ED include expectant, medical, or surgical management. All are feasible, however time, logistics, and staffing involved in counseling and provision of EPL care in the ED are barriers to implementation. Comprehensive EPL care is cost effective and efficient, however there are no previous studies that have compared the outcomes of patients who receive comprehensive EPL care in the ED versus those who are referred for outpatient follow-up.
We will perform a retrospective cohort study of patients who present to the ED with symptomatic EPL and compare the time to completion of EPL between those who received comprehensive EPL care in the ED to those who are referred for outpatient follow up. We will also compare the number of complications and the time that patients spent in the ED for their care. We hypothesize that patients who receive comprehensive EPL care in the ED will have quicker completion of their miscarriage, with no difference in the number of complications, and will spend similar amounts of time within the ED as those who are referred for outpatient management.
This study will fill a critical gap in our knowledge regarding the effect of comprehensive EPL care in the ED on various factors and will hopefully shed light on the importance of providing this care.