Abstract:
OBJECTIVE:To assess total time for evaluation of women with first-trimester pregnancy concerns in an early pregnancy unit compared with an emergency department (ED) within a single safety net hospital system. METHODS:We performed a retrospective cohort study at Denver Health Medical Center from May 1, 2017, to April 30, 2018. All patients who presented to the early pregnancy unit and a random sample of patients who presented to the ED were identified, stratified by month. Patients were eligible if they were aged 12-55 years, hemodynamically stable, in the first trimester with a positive pregnancy test, and without a prior ultrasonogram. Evaluation time was calculated as difference between registration or check-in and the discharge time. We extracted patient demographics, reproductive histories, presenting symptoms, diagnosis, and management plans at time of discharge from the electronic medical record. Descriptive statistics and multivariate analyses were performed. Lastly, a preliminary analysis of total charges was conducted. RESULTS:Of 250 patients originally identified, 165 met inclusion criteria (79 from the early pregnancy unit and 86 from the ED). There was no statistical difference in race, ethnicity, or insurance type between groups. Median evaluation time was significantly reduced in the early pregnancy unit compared with the ED (45 minutes [interquartile range 31-61] vs 236 minutes [interquartile range 173-307], respectively, P<.001). After adjusting for patient characteristics and clinical presentation, the average total evaluation time among patients in the early pregnancy unit (36 minutes) was 80% lower compared with patients in the ED (180 minutes). Median evaluation charges were significantly less for patients in the early pregnancy unit compared with those in the ED ($586.22 [interquartile range 384.83-757.34] vs $1,350.97 [interquartile range 975.77-3,553.62], respectively, P<.001). CONCLUSION:Time and charges for evaluation of women with first-trimester pregnancy concerns were significantly lower in an early pregnancy unit compared with an ED. Early pregnancy units should be considered as an alternative care model for patients in the first trimester of pregnancy in the United States.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
VanArendonk SH,Rockhill K,Stickrath EH,Alston MJdoi
10.1097/AOG.0000000000004080subject
Has Abstractpub_date
2020-11-01 00:00:00pages
995-1000issue
5eissn
0029-7844issn
1873-233Xpii
00006250-202011000-00020journal_volume
136pub_type
杂志文章abstract::The population of women who sell or exchange sex or intimate sexual services for material goods or services, also called "sex work," often is unrecognized in the typical obstetric and gynecologic practice. The prevalence of this behavior among adult women is difficult to quantify because of its frequent omission from ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000002163
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term effect of tubal sterilization on menstrual indices and pelvic pain. METHODS:Five hundred women undergoing sterilization were interviewed before sterilization, 6-10 months after surgery, and 3-4.5 years later. Four hundred sixty-six non-sterilized comparison women were interviewed in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVE:To compare the effects of single and repeated courses of corticosteroids on brain growth in fetal sheep. METHODS:Pregnant sheep were given intramuscular betamethasone (0.5 mg/kg) at 104 days' gestation followed at 111, 118, and 124 days by equivalent volumes of sterile normal saline (n = 12) or betamethasone...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00265-3
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To assess the relationship of preinsertion vaginal ultrasound assessment and menstrual and gynecologic history as predictors of difficult or painful intrauterine device insertion in nulligravid women. METHODS:Nulligravid women seeking contraception were invited to participate in this nonrandomized study and ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000362
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:We sought to relate the risk of antepartum stillbirth to uterine artery Doppler flow velocimetry at 22-24 weeks. METHODS:Data were available from 30,519 unselected women from seven units in the UK who had uterine artery Doppler performed between 22 and 24 weeks of gestation. The risk of stillbirth (n=109) wa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000248536.94919.e3
更新日期:2007-01-01 00:00:00
abstract::The author recounts her recent "high-risk" pregnancy. She relates the feelings experienced by many women in this situation, with the added insights of a certified nurse midwive. The author observes how these insights can be applied by health professionals who deliver care to expectant families. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-07-01 00:00:00
abstract::The authors describe a pregnancy complicated by rhesus sensitization and the May-Hegglin anomaly. The principal objective in caring for the patient was prevention of maternal and fetal hemorrhage. Transfusion of type-specific platelets corrected the patient's abnormal bleeding time. Cesarean section resulted in delive...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::Chemotherapy and radiation treatment for malignancies or other conditions such as hematologic and autoimmune disorders, have resulted in improved survival rates but may lead to sterility. Women who postpone conception until late reproductive years are also at increased risk to become infertile. The purpose of our revi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0b013e31818bba31
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence, magnitude, and type of fetal acidemia associated with contemporary obstetric anesthetic techniques. METHODS:Umbilical artery blood gases were obtained in 1601 singleton pregnancies delivered by elective cesarean. RESULTS:General anesthesia was used in 371 (23%) women, epidural i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)p4401-9
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To describe the technique and complications of vaginal repair of advanced pelvic organ prolapse using intravenous sedation, pudendal nerve block, and local anesthesia. METHODS:A retrospective review of the gynecologic surgical records of 20 patients was performed. Patient demographics, surgical procedure, su...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00331-k
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To compare sexual function in women with and without uterovaginal prolapse and urinary incontinence. METHODS:Eighty women with prolapse and with or without incontinence and 30 continent women without prolapse completed questionnaires assessing sexual function and underwent a physical examination. RESULTS:Wo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00434-F
更新日期:1995-04-01 00:00:00
abstract::Repair of vesicovaginal fistulas resulting from obstetric trauma remains a major challenge to surgeons worldwide. Large defects that result in partial or total urethral loss are especially difficult to repair. Even when closure of such fistulas is accomplished, return of normal urogenital function is often impaired, u...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199203000-00026
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:To identify the primary etiology of preterm birth in women with systemic lupus erythematosus, analyzing prospective data collected on 66 pregnancies in 58 women followed-up at a lupus pregnancy center. METHODS:Hospital records were reviewed and subjects were interviewed for pregnancies delivered after 23 com...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00186-U
更新日期:1995-09-01 00:00:00
abstract::The effectiveness of the carbon dioxide laser was evaluated in the treatment of penile, anorectal, and urethral condylomata acuminata in 40 men. All but six cases of urethral condylomata were prior conventional treatment failures. Postlaser follow-up ranged between one and two years, with an average of 16 months. No p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract::Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective opti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001583
更新日期:2016-08-01 00:00:00
abstract::Despite significant changes in management of labor and delivery over the past few decades, operative vaginal birth remains an important component of modern labor management, accounting for 3.3% of all deliveries in 2013 (1). Use of obstetric forceps or vacuum extractor requires that an obstetrician or other obstetric ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000003765
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To compare the odds of a good perinatal outcome between cryopreserved and fresh donor oocytes. METHODS:We used the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System to conduct a retrospective cohort study of women undergoing donor oocyte in vitro fertilization (IVF) from 2012 to 2...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003695
更新日期:2020-03-01 00:00:00
abstract::The midtrimester abortion program at a large community hospital was evaluated. During the 3-year study, 1839 patients aborted in the midtrimester by intraamniotic injection of hypertonic saline, prostaglandin F2alpha or a combination of saline and prostaglandin F2alpha. The method, using a combination of saline and pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract:OBJECTIVE:A multicenter, randomized placebo-controlled trial among women with singleton pregnancies and a history of spontaneous preterm birth found that weekly injections of 17 alpha-hydroxyprogesterone caproate (17P), initiated between 16 and 20 weeks of gestation, reduced preterm birth by 33%. The current study esti...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.AOG.0000150560.24297.4f
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To evaluate fetal outcome and long-term impact of very early preterm premature rupture of membranes (PROM). METHODS:In a retrospective cohort study, 78 women with singleton pregnancies who delivered at the Oulu University Central Hospital between 1990 and 1996 and who had early PROM, between the 17th and 30t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00213-0
更新日期:1998-09-01 00:00:00
abstract::Ultrasonic surgical aspiration is a useful technique for safe and accurate tissue removal. This study was conducted to evaluate its role in noninvasive vulvar disease. From December 1988 to March 1990, 27 patients underwent ultrasonic surgery; nine patients had vulvar intraepithelial neoplasia (VIN) and 18 had condylo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the Interstitial Cystitis Symptom Index and Problem Index as a screening tool for interstitial cystitis, and to estimate the prevalence and risk factors for interstitial cystitis in women with chronic pelvic pain. METHODS:Forty-five women scheduled to undergo laparoscopy for chronic pelvic pain w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02087-2
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To examine some of the controversy that still exists regarding the definition and management of microinvasive or early invasive cervical carcinoma, in particular, the current concepts regarding the definition of these conditions and their inclusion into the staging system for cervical cancer. DATA SOURCES:A ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0029-7844(96)00051-8
更新日期:1996-06-01 00:00:00
abstract::To determine whether amnio-polymerase chain reaction (amnio-PCR) can replace conventional cytogenetic study for confirming the karyotype of fetuses in women with positive biochemical screening for fetal Down syndrome. To check the accuracy of this technique in our laboratory, we first compared the amnio-PCR results wi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00222-9
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To improve health among newborn infants of pregnant adolescents in Portugal, we developed and evaluated a prenatal care intervention. METHODS:The study group consisted of 80 adolescents recruited as they registered for prenatal care at Hospital Santa Maria in Lisbon. The intervention consisted of three compo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Anterior sacral meningocele is a rare abnormality. Only 14 cases of it have been reported in association with pregnancy. Of those 14 patients, three died as a result of rupture of the meningocele during labor and postpartum. A new case is presented; the clinical presentation, the diagnosis, and treatment are discussed...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:To examine cigarette smoking as a risk factor for different types of epithelial ovarian cancer. METHODS:We used data from the Cancer and Steroid Hormone Study, a multicenter, population-based, case control investigation. Cases were 447 women aged 20-54 years with diagnoses of epithelial ovarian cancer. Contr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0029-7844(99)00531-1
更新日期:2000-02-01 00:00:00
abstract::Studied was the peripheral bone density of 39 women (ages 18 to 43) with the diagnosis of secondary amenorrhea in an effort to define the population of amenorrheic women at risk for osteoporosis. Eight women had exercise-induced amenorrhea (athletes), 20 women had amenorrhea associated with weight loss, and 11 women h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract::This article, for the "To the Point" series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, supplies educators with a review of best practices regarding incorporation of the electronic medical record (EMR) into undergraduate medical education. The uniqu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0000000000001004
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:To estimate the association between state Medicaid coverage of medically necessary abortion and severe maternal morbidity and in-hospital maternal mortality in the United States. METHODS:We used data on pregnancy-related hospitalizations from the Nationwide Inpatient Sample from 2000 to 2011 (weighted n=38,0...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001982
更新日期:2017-05-01 00:00:00