Archives of Gynecology and Obstetrics

, Volume 297, Issue 5, pp 1131–1135 | Cite as

Emergency department use during pregnancy: a prospective observational study in a single center institution

  • Fabinshy ThangarajahEmail author
  • Christina Baur
  • Stefanie Hamacher
  • Peter Mallmann
  • Verena Kirn
Maternal-Fetal Medicine



Gynecologists working in emergency department services in hospitals lately have the impression that the number of pregnant women who present themselves because of anxiety or uncertainty is increasing. Hence, the aim of this study was to assess reasons of pregnant women for presenting themselves to an emergency department. Of special interest was how far a diagnosis could be confirmed for the symptoms pregnant women complained about.


This is a prospective questionnaire-based study conducted between April 2015 and April 2016 in the Department of Gynecology and Obstetrics of the University Hospital of Cologne. The questionnaire was placed in the waiting area of the emergency department service for pregnant women. Pregnant patients were included with a gestational age of above 20 weeks of gestation.


331 patients were enrolled in this study. The most frequent reason for emergency department use was “pain” in 28.3% and cervical insufficiency in 19.7% of all cases. 45.6% (n = 151) of the patients had a recommendation of an outpatient practice for presentation to emergency department service. 36.3% (n = 120) of all patients were admitted to hospital for further treatment, 58.6% (n = 194) could be released from hospital. 3.3% (n = 11) of all patients rejected recommended further treatment in hospital. A trend was demonstrated concerning former abortion and hospital admission (p = 0.062).


The high amount of patients making nonurgent use of emergency department services indicates potential uncertainty in interpretation of symptoms. Patients with former abortion history were admitted more often to hospital, and therefore need special attention during pregnancy.


Emergency department use Pregnancy Admission 


Author contributions

FT: study concept, manuscript writing, data collection, analysis, and the literature research. CB: data collection, data handling, study concept, and manuscript editing. SH: data handling and manuscript editing. PM: study concept and manuscript editing. VK: study concept, manuscript writing, data collection, and analysis. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics Committee of the University Hospital of Cologne) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

404_2018_4684_MOESM1_ESM.pdf (248 kb)
Supplementary material 1 (PDF 248 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity Hospital CologneCologneGermany
  2. 2.Institute of Medical Statistics, Informatics and EpidemiologyUniversity of CologneCologneGermany

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