Management of bleeding in early pregnancy in accident and emergency departments
BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6954.574a (Published 03 September 1994) Cite this as: BMJ 1994;309:574
- G Gilling-Smith,
- P Toozs-Hobson,
- D J Potts,
- R Touquet,
- R W Beard
- Accident and Emergency Department, St Mary's Hospital, London W2 1NY
- Correspondence to: Miss C Gilling-Smith, Department of Obstetrics and Gynaecology, St Mary's Hospital, London W2 1PG.
- Accepted 3 March 1994
Vaginal bleeding occurs in up to 20% of all pregnancies.1 Many women present to accident and emergency departments, rather than to general practitioners or antenatal clinics, because they provide open access on a 24 hour basis. Doctors in accident and emergency receive little training, however, in the management of gynaecological emergencies. We previously showed that the use of management guidelines and the provision of advisory leaflets to patients on discharge significantly enhanced the service provided to women with such bleeding, both by improving diagnostic accuracy and by reducing the numbers of unnecessary admissions or referrals.2 We examined the facilities provided by other accident and emergency departments in such cases.
Patients, methods, and results
We sent a questionnaire to 109 accident and emergency departments in England and Wales treating more than 20 000 new patients a year. We …