[Gynecological emergencies: A prospective study about patients purpose of consultation and outcome]

Aiming to evaluate the profile type, complaint and outcome of patients consulting a gynecologic emergency unit in order to enhance "real" emergencies and improve their management.

We enrolled prospectively 308 women consulting to Reims teaching hospital gynecologic emergency unit from the 15th of May to the 25th of June 2013.

Two hundred and fifty-seven women (83.4%) spontaneously consulted without previous medical examination. Two hundred and thirty-eight of them (77.3%) had already been through gynecologic emergency units and 99 (32.1%) had no regular follow-up. Pelvic pain and/or metrorragia were registered as main complaint for 219 patients (71.1%). Median age was thirty years old (±11) and an average forty-minute wait was recorded. Gynecologic ultrasound was the first exam to be performed after clinical examination for 255 patients (82.8%). Twenty-two (7.1%) were hospitalized for surgical procedures or medical care, respectively 10 (3.2%) and 12 (3.9%). Among 51 women addressed by another healthcare professional, 9 were hospitalized (17.6%) versus 12 hospitalized (4.7%) out of 257, when consulting without initial professional expertise. A significant relationship between hospitalizations and general practitioner consultation was found with an OR=4.34 (95%CI: 1.51-12.05, P=0.002). Main motive of consultation involving home treatment turned out to be on-going pregnancies (92 patients, 29.9%).

A large majority of gynecologic hospital consultations, responsible for time waste and professional monopolizing, can be treated by general practitioners and could contribute to a better management of life-threatening emergencies.