Submission ID 77401

Code P66
At the end of this workshop, participants will be able to:
Category Medical Education
Type Oral
Will the presenter be a: Student
Title The Effect of Expanding the Early Pregnancy Assessment Clinic (Epac) and Covid-19 on Emergency Department (Ed) and Urgent Care (Uc) Visits for Early Pregnancy Bleeding.
Background/Purpose To assess EPAC expansion and COVID-19 impact on referrals from all EDs/UCs on patient visits for early pregnancy complications in Winnipeg, Canada.
Methods Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1 year pre-COVID (March 12, 2019 to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021).
Results There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs 5180), diagnoses of threatened abortion (1895 vs 2283) and ectopic pregnancy (78 vs 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during-COVID compared to pre-COVID (5.1 ±4.4 hours vs 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs 456) and retained products (236 vs 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval.
Discussion Accurate identification of pregnancy complications was difficult with over 20% missing ICD 10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID but ectopic pregnancy operative management remained unchanged.
Keyword 1 Pregnancy
Keyword 2 EPAC
Keyword 3 Abortion
Abstract content most relevant to: (check all that apply) Continuing Professional Development (CPD) (faculty development, CME)
Undergraduate Medical Education
Abstract Track - First Choice Virtual Care
Authors Harley Bray
Harley Bray
Helen Pymar
Chau Pham
Tom Jelic
Fran Mulhall

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