We are aware that issues in early pregnancy is a common presentation to general practitioners, physicians in other specialities, midwives and nurses. Here we aim to provide you with enough information to help us to co-care for your patient when she presents with an early pregnancy problem.
If you think that this is an acute emergency (such as heavy bleeding or severe pain) then you are welcome to contact us directly on behalf of your patient or to refer them to our emergency service. Please provide your patient with a referral letter and ask them to check in with reception so as they can best be directed to the most appropriate area. The emergency clinic / out of hours service (OHS) is staffed by a midwife and SHO, with the back up of a Registrar or Consultant, as appropriate.
If you think that the problem is so acute that you need to transfer the patient to the hospital by ambulance then we would appreciate if you could kindly phone ahead and speak to either the OHS midwife or the Clinical Midwife Manager (CMM) in the Antenatal clinic. The staff in the emergency department will then discuss with the Early Pregnancy Assessment Unit (EPAU) when an assessment is best made, and we can facilitate an assessment that day if this is appropriate. Given how busy the unit is (we see 4000+ women a year), we would appreciate if referrals are appropriate to the patients clinical symptoms.
If your patients problem is not an acute emergency then you can refer them to the EPAU service by faxing a referral (with the patients contact details on it) to the number below. Depending on the womans gestational age and the indication for the ultrasound, an appointment will be given aiming for the time in the pregnancy where we can get the greatest information – this is usually around seven or eight weeks gestation, but will be individualised to the woman.
Women who have had a previous miscarriage or ectopic pregnancy who have attended our service before are given information on how to access an early pregnancy scan in a future pregnancy – we give them contact details and advise them to ring for an appointment early in pregnancy (as soon as they have a positive pregnancy test) and we will aim to give them an appointment at 7-8 weeks gestation.
The Early Pregnancy Assessment Unit (EPAU) is one of the busiest areas in the hospital, with over 3000 women attending here every year. The ultrasound will be performed by a trained midwife-sonographer, radiographer or doctor, with the backup of other members of staff as required. Because of the nature of the unit, our most senior members of staff work here.