Delayed ultrasound in patients with abdominal pain and vaginal bleeding during the first trimester of pregnancy.

OBJECTIVE

To determine if patients with abdominal pain and vaginal bleeding during the first trimester of pregnancy who have a low clinical likelihood of ectopic pregnancy are put at risk of adverse events by delaying ultrasonography 12-18 h after emergency department presentation.

METHODS

A retrospective chart review of all surgically proven ectopic pregnancies at our Institution over a 2-year period.

RESULTS

One hundred and seventeen cases of ectopic pregnancy were reviewed. Thirty-seven cases met predetermined criteria of 'clinical stability' at first presentation. These patients waited a median 14 h for diagnostic ultrasound with 62% waiting more than 12 h. No adverse events occurred while waiting for this diagnostic study.

CONCLUSIONS

Preliminary results suggest that pregnant patients with abdominal pain and vaginal bleeding in the first trimester who meet specific low-risk clinical criteria could potentially have ultrasound delayed 12-18 h without risk of adverse event. Further prospective studies are warranted to confirm the safety of this strategy.