title: Prospective outcomes of pregnant ED patients with documented fetal cardiac activity on ultrasound.
abstract: BACKGROUND
  Evaluation of rates of spontaneous abortion (SAB) may aid in counseling pregnant patients seen in the emergency department (ED). A recent chart review reported an SAB rate of 10% among ED patients with a documented intrauterine pregnancy (IUP) and cardiac activity on ultrasound. We sought to prospectively evaluate outcomes among pregnant ED patients with documented cardiac activity on ultrasound.
  
  
  METHODS
  We prospectively enrolled a convenience sample of pregnant patients presenting to the University of Utah ED between January 1, 2008, and April 30, 2009. Ultrasound was performed during the ED visit. Patient outcomes were followed up 30 days after the ED visit. Patients were contacted by telephone or the medical record was reviewed for documentation of pregnancy status.
  
  
  RESULTS
  Seventy-one patients with an IUP and documented fetal cardiac activity were enrolled. We were able to obtain 30-day follow-up information on 61 patients (85.9%). Average patient age was 26.7 years (range, 17-42 years), average reported gravida was 3.3 (range, 1-8), and average gestational age was 10 weeks. Nine patients (14.8%; 95% confidence interval, 8.7%-23.9%) either reported or had a documented SAB during the 30 days after the ED visit.
  
  
  CONCLUSIONS
  In this study, which represents the first prospective evaluation of ED patients with documented IUP with fetal heart tones, the rate of SAB was consistent with that reported previously for this population. These results confirm that ED patients represent a high-risk group, and additional research is needed to better characterize risk factors for SAB.
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mallin
authors.forename: Matthew
authors.initials: M
authors.lastname: Dawson
authors.forename: Erika
authors.initials: E
authors.lastname: Schroeder
authors.forename: Burke
authors.initials: B
authors.lastname: Hatch
authors.forename: Isaac
authors.initials: I
authors.lastname: Jackson
authors.forename: Matthew
authors.initials: M
authors.lastname: Ahern
authors.forename: Chris
authors.initials: C
authors.lastname: Bossart
authors.forename: Troy
authors.initials: T
authors.lastname: Madsen
mesh_terms: D015746:Abdominal Pain; D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011258:Pregnancy Tests; D011446:Prospective Studies; D012306:Risk; D016216:Ultrasonography, Prenatal; D014589:Utah; D014592:Uterine Hemorrhage; D055815:Young Adult