OBSTETRICS AND GYNECOLOGY/CLINICAL POLICY Clinical Policy: Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy

This clinical policy from the American College of Emergency Physicians is the revision of the 2003 Clinical Policy: Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy. A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the btain a pelvic ultrasound in a clinically stable pregnant patient ho presents to the emergency department (ED) with bdominal pain and/or vaginal bleeding and a beta human horionic gonadotropin ( -hCG) level below a discriminatory hreshold? (2) In patients who have an indeterminate ransvaginal ultrasound, what is the diagnostic utility of -hCG or predicting possible ectopic pregnancy? (3) In patients eceiving methotrexate for confirmed or suspected ectopic regnancy, what are the implications for ED management? vidence was graded and recommendations were developed Annals of Emergency Medicine 381 a h w p i a c i r p d E r r a c