Spontaneous Abortion - Emergency Nurses Association

EMERGENCY NURSES ASSOCIATION
POSITION STATEMENT
PATIENTS WITH SPONTANEOUS ABORTIONS IN THE
EMERGENCY DEPARTMENT
Spontaneous abortions occur in approximately 20% of all pregnancies (Heminski, 1998). Many
patients present to the emergency department for diagnosis and treatment of pregnancy failure
during the first trimester of pregnancy. Termination of an incomplete abortion may be
accomplished with conservative medical management or (Ballagh & Harris, 1998) by a uterine
evacuation in the emergency department.
Spontaneous abortion evokes many emotions as well as physical pain and discomfort.
Emergency nurses must have adequate resources to care for these patients in the competent and
compassionate manner which their emotional and physical condition demand (Scroggins,
Smucker, & Krishen, 2000).
Care of patients experiencing spontaneous abortion requires competency, caring and compassion
provided by appropriate nursing staff. To best protect the patient, it is necessary that they be
cared for by educated caregivers with access to the appropriate resources.
1. ENA believes that completion of spontaneous abortions should be accomplished within
an appropriate and controlled setting, which usually necessitates transfer out of the
emergency department.
2. ENA believes that the physical and emotional needs of a patient undergoing uterine
evacuation must be met with appropriate physical and personnel resources.
3. ENA believes that collaborative decision-making with attention to the emotional and
informational needs of the patient should be utilized in the care of patients experiencing
spontaneous abortion.
4. ENA believes that every effort should be made to alleviate the physical pain of the
completion of the miscarriage advocates the administration of regional/local anesthesia
and/or conscious sedative agents.
5. ENA believes that appropriate follow-up referral is an integral portion of emergency care.
References
Ballagh, S., & Harris, H. (1998). Is curettage needed for uncomplicated incomplete spontaneous
abortion? American Journal of Obstetrics and Gynecology, 179(5), 1279-1282.
Heminski, E. (1998). Treatment of miscarriage: Current practices and rationale. Obstetrics and
Gynecology, 91(2), 247-53.
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Scroggins, K., Smucker, W., & Krishen, A. (2000). Spontaneous pregnancy loss: Evaluation,
management, and follow-up counseling. Primary Care: Clinics in Ofice Practice, 27(1), 153-67.
Developed: 1993.
Approved by the ENA Board of Directors: December, 1993.
Revised and Approved by the ENA Board of Directors: April, 1995.
Revised and Approved by the ENA Board of Directors: February, 1998.
Approved by the Association of Women’s Health, Obstetric, & Neonatal Nurses (AWHONN):
1998.
Revised and Approved by the ENA Board of Directors: September, 2000.
© Emergency Nurses Association, 2000.
Emergency Nurses Association
915 Lee Street
Des Plaines, IL 60016-6569
847/460-4000
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