Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia; School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Australia; Emergency Department, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Australia; Department of Obstetrics and Gynaecology, Illawarra Shoalhaven Local Health District, Wollongong, Australia.
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia; Emergency Department, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Australia.
Australas Emerg Care. 2022 Mar;25(1):55-83. doi: 10.1016/j.auec.2021.04.006. Epub 2021 Jun 1.
Bleeding in early pregnancy occurs in approximately a quarter of all pregnancies and is a common reason for presentation to the Emergency Department (ED). This review combined current knowledge about experiences, interventions, outcomes and frequency of women presenting to the ED with per vaginal (PV) bleeding in the first 20 weeks of pregnancy.
This integrative literature review was conducted using electronic database and hand searching methods for primary research published from 2000; followed by screening and appraisal. Articles were compared and grouped to identify characteristics and patterns that guided the synthesis of categories.
Forty-two primary research articles met inclusion criteria. Four main categories related to experiences and outcomes of women with bleeding in early pregnancy presenting to the ED were identified: presentation frequency and characteristics; women and their partners' experiences in the ED; interventions and treatments; patient and health service outcomes.
Negative and often frustrating experiences are reported by women experiencing PV bleeding, their partners and ED healthcare providers. While strategies such as early pregnancy assessment services contribute to improved outcomes, the availability of these services vary. Further research is needed to identify specific needs of this group of women and their partners, and the staff providing their care in the ED, to inform strategies for improved quality of care.
大约四分之一的妊娠都会出现早期妊娠出血，这是急诊科就诊的常见原因。本综述综合了目前关于妊娠 20 周内阴道出血的女性到急诊科就诊的经历、干预措施、结局和频率的相关知识。
本综合文献综述使用电子数据库和手工搜索方法，对 2000 年以来发表的原始研究进行检索；然后进行筛选和评价。对文章进行比较和分组，以确定指导类别综合的特征和模式。
符合纳入标准的原始研究文章有 42 篇。确定了与到急诊科就诊的早期妊娠阴道出血女性的经历和结局相关的四个主要类别：就诊频率和特征；女性及其伴侣在急诊科的经历；干预措施和治疗；患者和卫生服务结局。
经历阴道出血的女性、其伴侣和急诊科医护人员报告了负面的、常常令人沮丧的经历。虽然早期妊娠评估服务等策略有助于改善结局，但这些服务的可用性存在差异。需要进一步研究以确定这一女性群体及其伴侣以及在急诊科为其提供护理的工作人员的具体需求，为改善护理质量的策略提供信息。
