Patients Presenting to the Emergency Department in Early Pregnancy

Publication Date: October 1, 2016
Last Updated: March 14, 2022

Recommendations

Patient Management

Perform or obtain a pelvic ultrasound for symptomatic pregnant patients with any β-hCG level. (B)
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Do not use the β-hCG value to exclude the diagnosis of ectopic pregnancy in patients who have an indeterminate ultrasound result. (B)
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Obtain specialty consultation or arrange close outpatient follow-up for all patients with an indeterminate pelvic ultrasound result. (C)
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Recommendation Grading

Overview

Title

Patients Presenting to the Emergency Department in Early Pregnancy

Authoring Organization

Publication Month/Year

October 1, 2016

Last Updated Month/Year

January 16, 2024

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

This clinical policy from the American College of Emergency Physicians is an update of the 2012 Clinical Policy: Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy

Target Patient Population

Early pregnant patients with abdominal pain/vaginal bleeding

Inclusion Criteria

Female, Adolescent, Adult

Health Care Settings

Emergency care, Hospital

Intended Users

Paramedic emt, nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D011247 - Pregnancy, D011248 - Pregnancy Complications, D011271 - Pregnancy, Ectopic, D019522 - Vaginal Discharge, D015746 - Abdominal Pain

Keywords

pregnancy, ultrasound, emergency medicine, ectopic pregnancy

Source Citation

Ann Emerg Med. 2017;69:241-250.

Methodology

Number of Source Documents
40
Literature Search Start Date
September 1, 2009
Literature Search End Date
July 13, 2015