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Assessment and management of issues in early pregnancy

02 December 2021
Volume 13 · Issue 12


Approximately 5% of the workload of UK emergency ambulance services involves managing obstetric patients. This places pregnancy firmly within the scope of prehospital care but training often focuses on critical illness during pregnancy rather than the range of presentations seen. This clinical review aims to discuss the implications of early pregnancy with a focus on ectopic pregnancy, rhesus incompatibility, miscarriage and hyperemesis gravidarum. Normal presentations of pregnancy and alternative management strategies, including early pregnancy units, are also discussed.

Perhaps one of the less well-acknowledged demographics seen in prehospital care is the obstetric patient. This demographic makes up 5% of the caseload managed by the London Ambulance Service, which means obstetrics is uncommon but certainly not rare (McLelland et al, 2016).

In addition, paramedic training often focuses on critical illness rather than the range of presentations seen during pregnancy.

In light of this minimal patient exposure, the current literature review aims to alleviate some of the mystery of lesser known issues that arise during early pregnancy (defined as ≤20 weeks' gestation) by discussing its assessment and management.

The objectives of this paper are to describe what are considered normal symptoms in pregnancy as well as looking deeper at some key pregnancy-associated conditions that may present within this time period. Ectopic pregnancy, miscarriage, rhesus incompatibility and hyperemesis gravidarum shall be discussed as they will be most relevant to the prehospital clinician.

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