Abstract
Vaginal bleeding and abdominal pain are symptoms indicative of a threat to pregnancy that prompt women to seek assistance from health care professionals. The purpose of the study was to present the characteristics of Emergency Medical Services (EMS) team interventions in cases of suspected miscarriage. The study involved a retrospective analysis of EMS team interventions in cases of suspected miscarriage carried out between January 2018 and December 2019 in Poland. Data obtained from Poland’s National Monitoring Center of Emergency Medical Services included emergency medical procedure records and EMS team dispatch records in electronic format. The mean patient age was 30.53 years. Most were primiparous (48.90%) and up to the 13th gestational week (76.65%). The most commonly reported symptom was vaginal bleeding (80.71%). EMS teams were most commonly dispatched in the winter (27.03%), between 7 A.M. and 6:59 P.M. (51.87%), in urban areas (69.23%), with urgency code 2 (55.60%), and in most cases, they transferred the patient to a hospital (97.53%). The present study addresses very important issues concerning the characteristics of Polish suspected miscarriage cases handled by different EMS team types, in different locations (urban vs. rural areas), and concerning patients in a different obstetric situation (gestational week, gravidity, parity). Our findings suggest a need for further studies in this field and for gestational health promotion activities to be implemented, specifically including actions to reduce the risk of vaginal bleeding during pregnancy.
Highlights
Symptoms such as spotting or bleeding, amniotic fluid leakage, abdominal pain, or lower back pain may be indicative of a miscarriage [1,2], or early spontaneous pregnancy loss, whereby a live or dead embryo or fetus is passed before 22 weeks of pregnancy [3].Vaginal bleeding is one alarming symptom occurring in many early pregnancies, which may precede a miscarriage [4,5]
Our study demonstrated that in the case of rural areas, Emergency Medical Services (EMS) teams were more often dispatched to women in the third or subsequent pregnancy and those who had a history of three or more deliveries
Our analyses showed that EMS teams were more often dispatched to primiparous women, in the third trimester of pregnancy, nulliparous women, and women who experienced miscarriage, and that the dominating symptoms were vaginal bleeding and abdominal pain
Summary
Vaginal bleeding is one alarming symptom occurring in many early pregnancies, which may precede a miscarriage [4,5]. The literature features many reports of the impact of a woman’s psychological health on her experience of pregnancy loss. Research demonstrates that women who had lost a pregnancy may experience sadness, shame, or guilt, in addition to symptoms of depression, grief, or anxiety, which may be transient or persist for a number of years. All of the above factors may affect the woman’s health or the course of subsequent pregnancies [6,7,8,9]
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