title: Contemporary Obstetric Triage.
abstract: OBJECTIVE
  The role of obstetric triage in the care of pregnant women has expanded significantly. Factors driving this change include the Emergency Medical Treatment and Active Labor Act, improved methods of testing for fetal well-being, increasing litigation risk, and changes in resident duty hour guidelines. The contemporary obstetric triage facility must have processes in place to provide a medical screening examination that complies with regulatory statues while considering both the facility's maternal level of care and available resources.
  
  
  OBJECTIVE
  This review examines the history of the development of obstetric triage, current considerations in a contemporary obstetric triage paradigm, and future areas for consideration. An example of a contemporary obstetric triage program at an academic medical center is presented.
  
  
  RESULTS
  A successful contemporary obstetric triage paradigm is one that addresses the questions of "sick or not sick" and "labor or no labor," for every obstetric patient that presents for care. Failure to do so risks poor patient outcome, poor patient satisfaction, adverse litigation outcome, regulatory scrutiny, and exclusion from federal payment programs.
  
  
  CONCLUSIONS
  Understanding the role of contemporary obstetric triage in the current health care environment is important for both providers and health care leadership.
  
  
  BACKGROUND
  This study is for obstetricians and gynecologists as well as family physicians.
  
  
  OBJECTIVE
  After completing this activity, the learner should be better able to understand the scope of a medical screening examination within the context of contemporary obstetric triage; understand how a facility's level of maternal care influences clinical decision making in a contemporary obstetric triage setting; and understand the considerations necessary for the systematic evaluation of the 2 basic contemporary obstetric questions, "sick or not sick?" and "labor or no labor?"
authors.affiliation: Associate Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Edward Allen
authors.initials: EA
authors.lastname: Sandy
authors.affiliation: Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Robert
authors.initials: R
authors.lastname: Kaminski
authors.affiliation: Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Hygriv
authors.initials: H
authors.lastname: Simhan
authors.affiliation: Associate Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Richard
authors.initials: R
authors.lastname: Beigi
mesh_terms: D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence / Q000592:standards; D005260:Female; D049671:History, 18th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007396:Internship and Residency; D007743:Labor, Obstetric; D009774:Obstetrics / Q000266:history / Q000331:legislation & jurisprudence / Q000592:standards; D010561:Personnel Staffing and Scheduling; D011247:Pregnancy; D011256:Pregnancy Outcome; D014218:Triage / Q000266:history / Q000331:legislation & jurisprudence / Q000592:standards; D014481:United States