Prospective analysis of the patients who applied to the emergency department with acute critical complaints during pregnancy and postpartum period

Prospective Analysis of the Patients Who Applied to the Emergency Department with Acute Critical Complaints during Pregnancy and Postpartum Period Objective: In our study, we aimed to investigate the demographic and clinical information of pregnant women who applied to Emergency Department of Çukurova University Hospital with critical complaints. Material and Method: Our study was performed prospectively in Emergency Department of Çukurova University Hospital between March 2020 - December 2020, with the approval of the Non-Invasive Clinical Research Ethics Committee of Çukurova University. 74 pregnant women who applied to our clinic with acute critical complaints and accepted to participate in the study were included in the study. Within the scope of the study, the data were obtained by taking anamnesis from the patients, evaluating the consultation notes made to the relevant departments, examining the Hospital Management System (HMS) diagnosis codes and recording the laboratory results. Results: As a result of the study, the data of 74 pregnant women were compiled. The average age of pregnant women has been determined as 30.4 years. Considering the history of the pregnant women, hypertension, asthma and epilepsy diseases were detected in 9 pregnant women. The largest group among the pregnant women presenting with critical complaints is those in the 3rd trimester period. Mean week of gestation at admission was found to be 30.8. When the application complaints of the pregnant women were examined, it was seen that the most complaint was vaginal bleeding (n = 21, 28.4%). The most common diagnosis for pregnant women was preeclampsia (23%). During the Emergency Clinic application, the most consulted clinic is the Obstetrics and Gynecology clinic. 70 of the pregnant women were admitted to the Obstetrics and Gynecology service. 44 of the pregnant women gave birth during the emergency clinical application and hospitalization period and the average week of birth was determined as 33. There was no significant correlation between the length of stay of the patients and other data compared. 6 of the babies born were stillbirths, 15 were healthy births, and 23 were hospitalized in Neonatal Intensive Care. Mean birth week of stillborn babies was determined as 25.35 ± 6.18. When the results of the hemogram and biochemistry samples taken from the pregnant women were compared with the last condition of the baby, the blood HCO3 value of the pregnant women who had stillbirth was found to be significantly lower than the other groups. (p <0.05) White blood cell value was found to be significantly higher in pregnant women who had a stillbirth than the other groups. (p <0.05). Conclusion: In our study, it was determined that the most common reason for presentation of pregnant women who presented to the emergency department with critical complaints was vaginal bleeding. These patients should be consulted with the gynecology and obstetrics clinic for infant and maternal health. In addition to the routine examinations of pregnant women, the significant low level of sodium bicarbonate, especially in venous blood gas analysis, can be considered as a warning parameter for physicians. At the same time, it suggests whether low sodium bicarbonate in venous blood gas detected in pregnant women with stillbirth may be a laboratory indicator of severe fetal distress. As a result, the data to be obtained with more comprehensive studies on this subject will contribute to the improvement of maternal and infant health by determining the disease profiles that are common in our region. Key Words: Birth, Critical, Emergency Department, Epidemiology, Pregnancy