{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:50:42Z","timestamp":1782737442812,"version":"3.54.5"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Emergent postpartum hospital encounters in the first 42 days after birth are estimated to complicate 5 to 12% of births. Approximately 2% of these visits result in admission. Data on emergent visits and admissions are critically needed to address the current maternal morbidity crisis. Our objective is to characterize trends in emergent postpartum hospital encounters and readmissions through chief complaints and admission diagnoses over a 4.5-year period.<\/jats:p><jats:p>\n          Study Design\u2003All postpartum hospital encounters within 42 days of delivery at our institution from 2015 to 2019 were included. We reviewed demographic information, antepartum, intrapartum, and postpartum care and postpartum hospital encounters. Trends in hospital presentation and admission over the study period were analyzed. Comparisons between women who were admitted to those managed outpatient were performed. Statistical analysis included Chi-square, student's t-test, and Mantel\u2013Haenszel test for trend and ANOVA, as appropriate. A p-value &lt;0.05 considered significant.<\/jats:p><jats:p>\n          Results\u2003Among 8,589 deliveries, 491 (5.7%) presented emergently to the hospital within 42 days of delivery, resulting in 576 hospital encounters. From 2015 to 2019, annual rates of presentation were stable, ranging from 5.0 to 6.4% (p\u2009=\u20090.09). Of the 576 hospital encounters, 224 (38.9%) resulted in an admission with increasing rates from 2.0% in 2015 to 3.4% in 2019 (p\u2009=\u20090.005). Primiparous women with higher body mass index, cesarean delivery, and blood loss \u22651, 000\u2009mL during delivery were significantly more likely to be admitted to the hospital. Women with psychiatric illnesses increasingly utilized the emergency room in the postpartum period (6.7\u201317.2%, p\u2009=\u20090.03). The most common presenting complaints were fever, abdominal pain, headache, vaginal bleeding, wound concerns, and high blood pressure. Admitting diagnoses were predominantly hypertensive disorder (22.9%), wound complications (12.8%), endometritis (9.6%), headache (6.9%), and delayed postpartum hemorrhage (5.6%).<\/jats:p><jats:p>\n          Conclusion\u2003The average proportion of women presenting for an emergent hospital encounter in the immediate 42-day postpartum period is 5.7%. Nearly 40% of emergent hospital encounters resulted in admission and the rate increased from to 2.0 to 3.4% over the study period. The most common reasons for presentation were fever, abdominal pain, headache, vaginal bleeding, wound concerns, and hypertension. Hypertension, wound complications, and endometritis accounted for the top three admission diagnoses.<\/jats:p>","DOI":"10.1055\/s-0040-1712170","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T22:31:52Z","timestamp":1590877912000},"page":"1385-1392","source":"Crossref","is-referenced-by-count":18,"title":["A Gap in Care? Postpartum Women Presenting to the Emergency Room and Getting Readmitted"],"prefix":"10.1055","volume":"37","author":[{"given":"Shivani","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldeboran N.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin A.","family":"Macias","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Kraus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine Y.","family":"Spong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,5,30]]},"reference":[{"key":"ref1","first-page":"651","volume-title":"The puerperium","author":"F G Cunningham","year":"2018"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1046\/j.1523-536X.2002.00167.x","article-title":"Prevalence and persistence of health problems after childbirth: associations with parity and method of birth","volume":"29","author":"J F Thompson","year":"2002","journal-title":"Birth"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1097\/AOG.0b013e31826d60c5","article-title":"Severe maternal morbidity among delivery and postpartum hospitalizations in the United States","volume":"120","author":"W M Callaghan","year":"2012","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"38.e1","DOI":"10.1016\/j.ajog.2010.02.033","article-title":"Emergency department use during the postpartum period: implications for current management of the puerperium","volume":"203","author":"S L Clark","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/jocn.14090","article-title":"Postnatal ER visits within 30 days-pattern, risk factors and implications for care","volume":"27","author":"A Vikstr\u00f6m","year":"2018","journal-title":"J Clin Nurs"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1089\/jwh.2016.6309","article-title":"Emergency department visits for postpartum complications","volume":"27","author":"E C Brousseau","year":"2018","journal-title":"J Womens Health (Larchmt)"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1097\/AOG.0000000000002269","article-title":"Emergency department care in the postpartum period California births, 2009\u20132011","volume":"130","author":"P Batra","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s10995-018-2673-0","article-title":"Risk factors for postpartum emergency department visits in an urban population","volume":"23","author":"J J Sheen","year":"2019","journal-title":"Matern Child Health 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Gynecol"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1089\/jwh.2017.6437","article-title":"Severe maternal morbidity at delivery and risk of hospital encounters within 6 weeks and 1 year postpartum","volume":"27","author":"E M Harvey","year":"2018","journal-title":"J Womens Health (Larchmt)"},{"issue":"01","key":"ref15","first-page":"47","article-title":"Deciding to visit the emergency department for nonurgent conditions: a systematic review of the Literature","volume":"19","author":"L Uscher-Pines","year":"2013","journal-title":"Am J Manag Care"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1712170.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T14:54:45Z","timestamp":1620053685000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1712170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,30]]},"references-count":13,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2020,11,16]]},"published-print":{"date-parts":[[2020,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1712170","relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,30]]}}}