Emergency Department Visits for Postpartum Complications
Emergency Department Visits for Postpartum Complications
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DOI：
10.1089/jwh.2016.6309
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发表时间：
2018-03-01
影响因子：
3.5
通讯作者：
Matteson, Kristen A.
中科院分区：
文献类型：
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作者：
Brousseau, Erin Christine;Danilack, Valery;Matteson, Kristen A.
简介：大多数对产后并发症的患病率和类型的估计都是基于医院的再入院。然而，使用再入院数据（仅占产后女性的 1%-2%）是有问题的，因为它未能包括在办公室或急诊科 (ED) 评估的产后并发症的女性。我们利用在急诊室评估的一组女性的数据来更好地描述女性在产后经历的并发症。材料和方法：我们对 6 个月内前往三级妇科医院急诊室就诊的所有产后就诊进行了回顾性分析。我们描述了急诊就诊的人群特征和临床细节，特别是主诉、分娩类型、最终诊断和入院率。结果：在研究期间的 5708 例分娩中，有 252 名女性在产后 42 天内至少去过一次急诊室，首次就诊的中位时间为产后 7.5 天。最常见的主诉是伤口并发症（17.5%）、发烧（17.1%）、腹痛（15.9%）、头痛/头晕（12.3%）、乳房问题（10.7%）和高血压（10.3%）。其中 57% 的就诊妇女是阴道分娩的妇女，其中 54% 的妇女是经产妇女。最常见的最终诊断是产后检查正常，只有 22% 的女性再次入院。结论：产后到急诊室就诊的女性有各种各样的健康问题，但 78% 的人没有入院。鉴于许多就诊的时间安排和敏感性较低，更好的产后教育可能是减少非紧急产后急诊就诊的一种工具。
Introduction: Most estimates of the prevalence and types of postpartum complications are based on hospital readmissions. However, using hospital readmissions (which occurs in only 1%-2% of postpartum women) is problematic as it fails to include women with postpartum complications assessed in the office or emergency department (ED). We utilized data from a cohort of women evaluated in an ED setting to better characterize complications experienced by women in the postpartum period. Materials and Methods: We performed a retrospective analysis of all postpartum visits to the ED at a tertiary care women's hospital over 6 months. We described characteristics of the population and clinical details of the ED visit, specifically the presenting complaint, delivery type, final diagnosis, and admission rate. Results: Among 5708 deliveries during the study period, 252 women had at least one visit to the ED within 42 days after delivery, and the median timing for first visit was 7.5 days postpartum. The most common presenting complaints were wound complication (17.5%), fever (17.1%), abdominal pain (15.9%), headache/dizziness (12.3%), breast problem (10.7%), and hypertension (10.3%). Fifty-seven percent of these visits were by women who delivered vaginally and 54% of women were multiparous. The most common final diagnosis was a normal postpartum examination and only 22% of women were readmitted. Conclusion: Women presenting to the ED postpartum period had a wide variety of medical issues but 78% were not admitted. Given the timing and low acuity of many visits, better postpartum education may be a tool to reduce nonemergent postpartum ED visits.