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Pregnancy in the emergency department: risk factors and prevalence among all women
C L Stengel1, D C Seaberg, B A MacLeod
1University of Pittsburgh, Pennsylvania.
Study Objective:
To determine the prevalence of unrecognized pregnancy in the emergency department and to ascertain if patient history can effectively detect unrecognized pregnancies.
Design:
Prospective study.
Setting:
Urban ED with annual census of 40,000.
Participants:
One hundred ninety-one consecutive women meeting inclusion criteria.
Interventions:
All participants completed a menstrual/sexual history questionnaire and had a urine pregnancy test.
Results:
Overall, we found a 6.3% prevalence of unrecognized pregnancy. Women with abdominal/pelvic complaints had a 13% prevalence; those with other complaints had a 2.5% prevalence. Two historical risk factors, the patient's suspicion that she might be pregnant and an abnormal last menstrual period, had a statistically significant correlation with unrecognized pregnancy. A third risk factor, the presence of abdominal/pelvic complaints, nearly achieved statistical significance. These risk factors detected all unrecognized pregnancies with a sensitivity of 100% and a specificity of 54%.
Conclusion:
The prevalence of unrecognized pregnancy in our ED was 6.3%. Historical risk factors detected all of them.
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