• Kirsten Jay Hartwick Das, Colton Hood, Adam Rutenberg, and Veronica Gomez Lobo.
• Department of Obstetrics and Gynecology, The George Washington University, Washington, DC. Electronic address: kjh@gwu.edu.
• Ann Emerg Med. 2023 Apr 1; 81 (4): 396401396-401.

Study ObjectiveTo describe pediatric and adolescent obstetric and gynecologic diagnoses presenting at emergency departments (EDs) in the United States.MethodsThis was a retrospective, cross-sectional study design that utilized the Nationwide Emergency Department Sample (NEDS), which comprised hospital-owned EDs throughout the United States in 2018. The participants included a sample set of female patients from birth to 18 years old. All obstetric and gynecologic (OB/GYN) International Classification of Disease (ICD-10) codes were categorized. Descriptive, bivariate, and multivariate analyses were used to assess diagnoses by age group, hospital type, ED disposition (eg, admission and transfer), payer, and median household income.ResultsIn 2018, there were 518,244 OB/GYN ED visits by female patients aged less than or equal to 18 years. Vulvovaginal disorders and abnormal uterine bleeding were among the top 5 presentations in all age groups. The top diagnoses varied by age group. Diagnoses with higher morbidity and mortality (ovarian torsion and ectopic pregnancy) had higher admission and transfer rates compared with diagnoses that can be commonly managed in the outpatient setting (vulvar or vaginal disorders).ConclusionsThis is the first study that evaluated OB/GYN diagnoses in pediatric and adolescent patients presenting to the ED. Educational and referral efforts should focus on not only emergency diagnoses, such as ovarian torsion, adnexal masses, and ectopic pregnancy, but also common presentations that can often be managed in the outpatient setting, such as vulvovaginal disorders and abnormal uterine bleeding.Copyright © 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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