Emergency department care for early pregnancy loss: A scoping review of patient experiences and compassionate clinical practices in the United States.

BACKGROUND: Early pregnancy loss (EPL), including miscarriage and ectopic pregnancy, affects a significant proportion of pregnancies and often leads patients to seek urgent care in the emergency department (ED). Despite this, the quality of care received varies and individuals often have negative experiences. This scoping review provides a comprehensive overview of published research examining ED care for EPL, specifically focusing on patient experiences and compassionate clinical practices.

METHODS: The PRISMA-ScR checklist was utilized for the review. A literature search was performed to identify studies on individuals' health care experiences in the ED setting following EPL, with particular attention paid to compassionate or empathetic care and the practices used to provide it. Searches were conducted in PubMed, PsychInfo, SocINDEX, and CINAHL. Four reviewers independently screened the records.

RESULTS: Of the 89 records reviewed, 15 studies met the inclusion criteria.Themes emerging from the literature include an urgent need for improved education for ED healthcare professionals on accurate diagnosis, empathetic communication, and evidence-based management of EPL, standardized care protocols, and trauma-informed approaches tailored to reproductive loss.

CONCLUSION: Findings from the review can inform future efforts to redesign ED practices to support patient-centered EPL care, particularly as EDs remain the primary site for EPL management in the United States.