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Early Pregnancy Unit

Lead Consultant: Mr B Whitlow MD MRCOG

Lead Nurse: Clarissa Plowright

Early Pregnancy Unit Tel: 01206 742422
Fax:01206 742050

Introduction

Early pregnancy runs from the first positive pregnancy test to 19 weeks of pregnancy. The early pregnancy unit, is located on the ground floor of constable wing outpatients department. Referrals to the EPU should be made through your GP. Women with recurrent miscarriage can have reassurance scans with Mr Whitlow on Thursday mornings 9-11am by appointment.

Currently, should women have concerns about:

Pain, vaginal bleeding, excessive vomiting, in early pregnancy, then they should consult their GP / Midwife and if appropriate be seen on Stanway Ward at the Hospital by the emergency gynaecology team on call.

Stanway ward:
Telephone: 01206 742422 or 742035

The links below provide information on common problems in early pregnancy:
Pain and bleeding in early pregnancy
Miscarriage - the treatment options
Recurrent miscarriage
Ectopic pregnancy
Hyperemesis (excessive vomiting in pregnancy)
Molar pregnancy
PALS

Pain and bleeding in early pregnancy
Approximately 25% of ladies will experience bleeding in early pregnancy. Such a symptom may be due to a miscarriage, although frequently it will not be due to a miscarriage (50% of cases).
Pain in early pregnancy can be due to a number of causes, although it is important if you have pain in early pregnancy that you are assessed by your doctor and if appropriate an ultrasound scan arranged to ensure your pregnancy is within the womb (98% cases) and not ectopic (in the fallopian tube/outside the womb).

The web link below offers further information
www.babycentre.co.uk

Miscarriage - the treatment options
The following web page gives advice for women who may have suffered a miscarriage
Should you have any further questions, please contact Sister Liz Barnes, our Gynaecology Nurse Counsellor on 01206 742634 and she will be happy to assist you.

Recurrent miscarriage
A recurrent miscarriage is one where a lady has 3 miscarriages in a row (one after another). This represents only a small number of ladies (around 1%). The cause in such cases can be due to the following:

Ladies who have had 3 consecutive miscarriages should be assessed by a gynaecologist to investigate and assess whether a treatment is appropriate.

In the majority of cases, even with no treatment, most ladies will have a successful outcome given reassurance and support through their pregnancy by their doctor.

The web link below provides further information:
www.miscarriageassociation.org.uk

Ectopic Pregnancy
This is when the pregnancy implants outside the womb. This accounts for around 1-2% of all pregnancies. It usually presents before 9 weeks with pain and a small amount of vaginal bleeding. If you have these symptoms, then you should consult your doctor as to whether you should be assessed at the hospital to ensure you do not have an ectopic pregnancy.

The web link below provides more information:
www.ectopic.org

Hyperemesis Gravidarum (excessive vomiting in pregnancy)
Excessive vomiting in pregnancy is usually associated with a normal, healthy pregnancy. It can however be associated with twins, thyroid problems or a molar pregnancy (very rarely). It is important if you cannot keep oral fluid down (2 litres of fluid a day) and you are pregnant, that you are assessed by your doctor, as you may require a drip to rehydrate you. Other treatments are necessary sometimes, but usually correction of dehydration for 24-48 hours is all that is required most of the time.

The web link below provides more information:
www.hyperemesis.org

Molar pregnancy / hydatidiform mole
In the UK molar pregnancies occur at approximately 1 per 1000 registered births. It is known that the pregnancy goes wrong at the time of fertilisation of the egg by the sperm, but we don't yet know why this happens. There are 2 types of mole. It can be a "complete mole" in which there is no fetus at any time. Instead the afterbirth/ placenta grows as a series of cysts which look rather like grapes (hydatid means watery cyst). It can also be a "partial mole" in which there is evidence of a fetus although it cannot survive.

The web link below provides more information:
www.hmole-chorio.org.uk

PALS
The Patient Advice and Liaison Service (PALS) is a service that offers support, information and assistance to patients, relatives and visitors. They can also provide help and advice if you have concern or complaints that staff have not been able to resolve for you.

Visit our PALS web page for further information.