title: Decreased need for emergency services after changing management for suspected miscarriage.
abstract: We investigated the effect of a changed routine to identify women with a nonviable pregnancy, in order to utilize health care resources more efficiently during office hours rather than relying on emergency care services. From hospital register data about where and when women with miscarriages were treated, there was a significant trend during a nine-year period for miscarriages to be more rarely diagnosed (p-value<0.001) in the emergency ward after office hours. The proportion of miscarriages that were diagnosed and handled at the emergency ward decreased from 31% in 2001 to 17% in 2009. Furthermore, the number of women showing up with bleeding at the emergency ward, but who also had a normal viable pregnancy, declined during the same period (p-value<0.01). Women with suspected miscarriage benefit from structured information and standardized management and can effectively be scheduled for day-time assessment including ultrasound with a concomitant reduced need for emergency services.
authors.affiliation: Department of Obstetrics and Gynecology, Central Hospital Skövde, University of Skövde, Sweden. annsofie.adolfsson@his.se
authors.forename: Annsofie
authors.initials: A
authors.lastname: Adolfsson
authors.forename: Karin
authors.initials: K
authors.lastname: Tullander-Tjörnstrand
authors.forename: Per-Göran
authors.initials: PG
authors.lastname: Larsson
mesh_terms: D000022:Abortion, Spontaneous / Q000628:therapy*; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D011247:Pregnancy