(466) Outcome of Preterm Pregnancies Evaluated in Triage Settings.

Obstetrical care frequently involves evaluation in hospital triage setting for conditions associated with adverse pregnancy outcomes (APOs), but little is known about the outcomes of these visits. Our objective was to implement a registry of triage visits for possible APOs and evaluate the outcomes of these pregnancies.

Study Design: All triage visits occurring between 20^0/7 and 34^6/7 weeks' on randomly selected dates between 1/1/2019 and 3/31/2019 at 34 hospitals across the US were reviewed. Those in whom the reason for the visit was suspected preterm labor/preterm premature rupture of membranes (PTL/pPROM), fetal growth restriction (FGR), preeclampsia (PE) or antepartum bleeding were eligible. If a patient had more than one triage visit, only the first was included in the analysis. Data were abstracted by certified research nurses using predefined criteria. The primary outcome was time from triage to delivery. Secondary outcomes included preterm birth and mode of delivery.

Results: 3078 mother/newborn dyads with triage visit on 36 random days were included (average 85 cases per day). The distribution and baseline characteristics shown in Table 1. The median time from triage visit to delivery was 46 days (interquartile range 22 to 76 days], with FGR having the shortest latency of 13 days and antepartum bleeding having the longest with 52 days (Table 2). Subsequent preterm birth < 37 weeks occurred in 38% overall and ranged from 32% for PTL/pPROM to 75% for FGR (Table 2).

Conclusion: We successfully implemented a multisite registry of triage visits with rigorous ascertainment and data collection. Of the 4 APOs evaluated, suspected PTL/PPROM was the indication in 72% of the visits in this large network, and the majority did not deliver within 1 week (or preterm). Those evaluated in triage for suspected FGR had the shortest latency until delivery and the highest risk of preterm delivery. Triage visits represent a large burden on obstetrical services and more research to optimize cost versus benefit is warranted.