title: Antenatal Emergency Care Provided by Paramedics: A One-Year Clinical Profile.
abstract: To report on clinical and socio-demographic factors of a one-year caseload of women attended by a statewide ambulance service in Australia, who presented during pregnancy, prior to the commencement of labor.
  
  
  
  Retrospective clinical data collected via in-field electronic patient care record (VACIS®) by paramedics during clinical management was provided by Ambulance Victoria. Cases were electronically extracted from the Ambulance Victoria Clinical Data Warehouse via comprehensive filtering followed by case review.
  
  
  
  Over a 12-month period, paramedics were called to 2,098 women with pregnancy as a primary or non-primary clinical consideration. Women's ages ranged from 14 to 48 years. The majority were multigravidas (86%). There was a greater chance that ambulance services would be required during business hours than any other time of the day. Paramedics noted pregnant women required ambulance services for a range of primary presenting symptoms both obstetric (n = 1137) and non-obstetric (n = 961). Some women had pre-existing conditions including asthma, hypertension, and diabetes potentially complicating their pregnancies. Paramedics administered analgesia to one third of the women. Paired t-tests revealed significant improvement in the pain relief and overall vital signs of the women encountered. Less than half the women (n = 986, 47%) required interventions.
  
  
  
  This is a unique population wide analysis of ambulance service resource use exploring the clinical profile of pregnant women requiring ambulance services in one calendar year. To manage obstetric and non-obstetric complications in this population safely and effectively, paramedics require an understanding of the unique physiological adaptions during pregnancy. This study therefore has both educational and practice implications.
authors.forename: Gayle
authors.initials: G
authors.lastname: McLelland
authors.forename: Lisa
authors.initials: L
authors.lastname: McKenna
authors.forename: Amee
authors.initials: A
authors.lastname: Morgans
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians; D005260:Female; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D011295:Prenatal Care; D012189:Retrospective Studies; D014739:Victoria; D055815:Young Adult
keywords: ambulance; antenatal; paramedic; pregnancy; prehospital; unplanned