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Experiences and outcomes of women with bleeding in early pregnancy presenting to the Emergency Department: An integrative review

Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia; School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Australia; Emergency Department, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Australia; Department of Obstetrics and Gynaecology, Illawarra Shoalhaven Local Health District, Wollongong, Australia. Electronic address: baylie@uow.edu.au. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia; Emergency Department, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Australia. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia. Emergency Department, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Australia. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Australia; Emergency Services, Critical Care Division, Illawarra Shoalhaven Local Health District, Australia. Department of Obstetrics and Gynaecology, Illawarra Shoalhaven Local Health District, Wollongong, Australia. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia; Molly Wardaguga Research Centre, CDU, Darwin, Australia.

Australasian emergency care. 2021
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Abstract
BACKGROUND Bleeding in early pregnancy occurs in approximately a quarter of all pregnancies and is a common reason for presentation to the Emergency Department (ED). This review combined current knowledge about experiences, interventions, outcomes and frequency of women presenting to the ED with per vaginal (PV) bleeding in the first 20 weeks of pregnancy. METHODS This integrative literature review was conducted using electronic database and hand searching methods for primary research published from 2000; followed by screening and appraisal. Articles were compared and grouped to identify characteristics and patterns that guided the synthesis of categories. RESULTS Forty-two primary research articles met inclusion criteria. Four main categories related to experiences and outcomes of women with bleeding in early pregnancy presenting to the ED were identified: presentation frequency and characteristics; women and their partners' experiences in the ED; interventions and treatments; patient and health service outcomes. CONCLUSIONS Negative and often frustrating experiences are reported by women experiencing PV bleeding, their partners and ED healthcare providers. While strategies such as early pregnancy assessment services contribute to improved outcomes, the availability of these services vary. Further research is needed to identify specific needs of this group of women and their partners, and the staff providing their care in the ED, to inform strategies for improved quality of care.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine