419: Emergency postpartum hospital visits: who gets admitted?

Abstract

Emergent postpartum hospital encounters in the first 42 days after birth are estimated to complicate 5-12% of births. Approximately 2% of these visits result in admission. Data on emergent visits and admission during this time period is critically needed to address the current maternal morbidity crisis. Our objective is to characterize postpartum hospital encounters to the emergency room that resulted in admission. All postpartum hospital encounters within 42 days of birth from 2015 to 2019 at our institution were included. We reviewed demographic information, delivery route, and postpartum hospital encounters. Comparisons between women who were admitted to those managed outpatient were performed. Statistical analysis included Chi square and students t-test with p < 0.05 considered significant. Of the 8589 deliveries, 491 (5.7%) presented emergently to the hospital within 42 days of discharge and resulted in 576 hospital encounters. Of these hospital encounters, 224 (38.9%) resulted in an admission, accounting for 188 of the 491 deliveries (38.2%) re-admitted. Women with higher BMI, cesarean delivery, and blood loss ≥1000ml during delivery were significantly more likely to be admitted to the hospital (Table 1). Common chief complaints included fever, abdominal pain, headache, vaginal bleeding, wound, and hypertension (Figure 1). Admitting diagnoses were predominantly hypertensive disorder (21.0%), wound complications (11.6%), endometritis (11.2%), delayed postpartum hemorrhage (4.9%), and headache (4.5%) (Figure 1). Approximately 6% of deliveries are complicated by an emergency hospital visit within 42 days of discharge. Nearly 40% of emergent hospital encounters resulted in admission. The most common reasons for admission were hypertension, endometritis, and wound complications.View Large Image Figure ViewerDownload Hi-res image Download (PPT)