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The Early Pregnancy Unit (EPU) and Urgent Gynaecology Care Centre (UGCC) are designated places where women with early pregnancy or emergency gynaecology problems can be reviewed. See the relevant tab below for more information.

The Early Pregnancy Unit is an emergency referral service providing care for women experiencing pregnancy complications, primarily pain or vaginal bleeding, up to 15+6 weeks.

This may be a stressful time for both couples and their families and the unit aims to support you through the early stages of your pregnancy.

As this is an emergency service for women, it works as an extension to the Emergency Department. 

What happens when you visit the Early Pregnancy Unit?

When you arrive at the unit you will be booked in by a receptionist who will confirm your details. If appropriate you will then be taken to have an ultrasound by one of our experienced sonographers or senior doctors. 

The scan is usually an internal scan as this makes it easier to get detailed images of what is happening with your pregnancy. This may be uncomfortable but will not harm your pregnancy. You may decline an internal scan, in which case an abdominal scan can be performed instead.

If required you will then have a further review which may include blood tests and a follow up plan - use this opportunity to ask any questions you may have. 

These processes can often take some time but the team will always endeavor to complete your clinical assessments promptly.

What are the likely outcomes of my scan?

The possible outcomes of your scan are:

  • Normal pregnancy
  • Miscarriage
  • Ectopic pregnancy
  • Pregnancy of unknown location (a positive pregnancy test but no pregnancy found on scan)
  • Pregnancy of uncertain viability
  • Molar pregnancy

Please note that pain and bleeding are common symptoms in early pregnancy.

Management options

After review of the scan, you may be offered the following treatments:

For miscarriage:

  • Conservative or expectant management (natural)
  • Medical management (tablets)
  • Surgical management (Manual Vacuum Aspiration (MVA) under local anaesthetic or surgical management of miscarriage under general anaesthetic)

For ectopic pregnancy:

Management is discussed on an individual basis but can include conservative, medical or surgical procedures. 

Referrals

We accept referrals of early pregnancy patients with pain and bleeding from GP, midwife, emergency department and NHS 111 services. We sometimes accept self-referrals from patients if they have difficult accessing their GP surgery due to Covid restrictions.

You can self-refer if you have a history of:

  • previous confirmed ectopic pregnancies
  • molar pregnancy
  • recurrent miscarriage (3 consecutive early pregnancy losses)

If you are eligible for self-referral you should call when you have a confirmed positive pregnancy test so that the team can organise an appropriately timed appointment. 

Early Pregnancy Unit Matrons: Fiona Walton (FPH) and Alison Welch (WPH)

Women, 16 years and over, who are clinically stable can be referred to the UGCC with the following symptoms:

  • Vaginal swelling e.g. Bartholin's cyst/ abscess
  • Abdominal/ pelvic pain
  • Intrauterine contraceptive device issues
  • Post termination complications
  • Over 4 week postpartum retained products of conception (under 4 weeks should seek advice from maternity triage department)
  • Post-operative complications within 14 days of surgery

Minor procedures that can be carried out in the centre include:

  • Insertion of word catheter for Bartholin's cyst/ abscess 
  • Incision and drainage of vulval/ labial abcesses under local anaesthetic

Unfortunately the centre is unable to see women who:

  • Are medically unstable or unwell
  • Have non-urgent gynaecological issues e.g chronic abdominal pain/ menorrhagia
  • Have post-menopausal bleeding
  • Need a pessary change

Urgent Gynaecology Care Centre Matrons: Fiona Walton (FPH) and Alison Welch (WPH)

Feedback, compliments and complaints
Should you wish to express your satisfaction with the service we have provided you can do this by emailing fhft.patientexperience@nhs.net.

If you feel dissatisfied with your care please ask to speak to the lead nurse, if they cannot resolve your concern, please contact the Patient Advice and Liaison Service.