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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 4

(962) Impact of emergency room abortion bans on pregnancies with previable PPROM: A Cost-Effectiveness Analysis

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective: Preterm premature rupture of membranes (PPROM) is a serious condition that affects 0.4-0.7% of all pregnancies. Pregnancies with PPROM are associated with increased neonatal morbidity and mortality. Additionally, children surviving PPROM have higher rates of physical disability and neurodevelopmental delay. Under the Emergency Medical Treatment and Labor Act (EMTALA), any patient who presents with an emergency medical condition must be appropriately screened and stabilized, including instances in which treatment entails stabilization through emergency abortion. This analysis evaluated the cost-effectiveness of emergency abortions for previable PPROM between 18-22 weeks.  

Study Design: In this analysis, a TreeAge model was created to compare outcomes in previable PPROM patients with emergency abortion available to those who do not have access to emergency abortion under EMTALA. The cohort consisted of 1,183 individuals, the estimated number of pregnant people with previable PPROM seeking abortion. Clinical outcomes measured in the model included chorioamnionitis, maternal sepsis, maternal death, stillbirth, neonatal death, and neurodevelopmental delay. Probabilities, utilities and costs were derived from literature. QALYs were discounted at a rate of 3%.

Results: In this theoretical cohort, abortion access under EMTALA was associated with a decrease of 12 cases of maternal sepsis, 1 case of maternal death, 621 cases of stillbirth, 125 cases of neonatal death, and 95 cases of neurodevelopmental delay. Emergency abortion availability was the dominant strategy as it saved $97,131,562 and led to 1,952 additional QALYs.

Conclusion: Restrictive abortion bans that bar emergency abortion as care to treat previable PPROM results in increased maternal morbidity and mortality, as well as increased costs and decreased quality of life.