Emergency Physicians’ Role in the Medication and Procedural Management of Early Pregnancy Loss

Originally approved September 2024

The American College of Emergency Physicians (ACEP) affirms that early pregnancy loss (loss of a pregnancy before 13 weeks gestation) is a common and potentially life-threatening emergency department diagnosis. Early pregnancy loss is addressed through medical management, procedural management (including surgery and manual uterine aspiration), and/or expectant management.

ACEP recognizes that ectopic pregnancy is a complication of early pregnancy and a medical emergency that threatens the life of a mother. ACEP affirms that both medical and surgical management of ectopic pregnancy can be life-saving, and ACEP supports the widespread availability of each of these options.

ACEP supports that in all situations of early pregnancy loss and ectopic pregnancy where maternal life is potentially at risk, appropriate measures are taken by the emergency physician to prevent an increase in maternal morbidity or mortality.

ACEP supports and encourages emergency physicians practicing in low-resource environments, including hospitals with limited or absent labor and delivery services, to obtain supplemental training and proficiency in the medical and procedural management of early pregnancy loss, as these can be life-saving interventions.

ACEP supports and advocates for evidence-based care in the setting of early pregnancy loss and ectopic pregnancy. Further, ACEP opposes the criminalization of medically necessary care or penalization of patients, physicians, nurses, and other health care workers, as well as health systems engaged in medically appropriate care of patients with early pregnancy loss and ectopic pregnancy.