Early Pregnancy Unit (EPU): Patient Leaflets

Early Pregnancy Unit

Your doctor has requested that you attend this Assessment Unit because a problem has arisen during the early stages (first 12 weeks) of your pregnancy.

This is an emergency service for women referred by their GP, midwife, A& E or healthcare professionals with pain and /or vaginal bleeding in early pregnancy.

The aims of the unit are to offer help and assistance with the pregnancy related problem you are experiencing.

Blood Clot Risk-Assessment Questionnaire

This questionnaire is designed to find out if you are at high risk of having blood clots (known as venous thromboembolism or VTE) in early pregnancy.

You should fill in this questionnaire if you are pregnant but have not yet had an appointment (known as the booking appointment) with a midwife

Bleeding and Abdominal Pain in Early Pregnancy

This leaflet has been produced to give you general information about bleeding and abdominal pain during early pregnancy. This leaflet will guide you through what’s normal, what might require attention, and when you should seek medical help.

Progesterone Treatment for the Management of Bleeding During Early Pregnancy

The use of progesterone treatment for the management of bleeding during early pregnancy

The National Institute for Health & Care Excellence (NICE) offered guidance in 2021 for progesterone treatment for the management of bleeding during early pregnancy following the results of a large research study called ‘PRISM’ that was carried out across 48 Hospitals in the UK in 2019.

Pregnancy of Unknown Location (PoUL)

A pregnancy of unknown location means that you are pregnant but your pregnancy cannot be seen on a transvaginal ultrasound scan.

Consent for Laboratory Examination and Cremation or Sensitive Disposal of Early Pregnancy Loss up to 11+6 weeks

We are sorry that your pregnancy is no longer progressing following confirmation of a miscarriage or an ectopic pregnancy. We understand this is a difficult time for you and we will do our best to support you and your partner as you process and come to terms with your loss. Your decisions are important to us. This information is provided to assist you in choosing whether your pregnancy tissue is examined and deciding how the pregnancy loss will be disposed.

Conservative Management of Miscarriage

We are very sorry that your pregnancy is no longer progressing. We understand this may be a very distressing time for you. Sadly, miscarriages are known to occur in 1 in 4-5 pregnancies. In early pregnancy, the most common reason for a miscarriage is a genetic abnormality within the baby and so is out of your control.

We hope that this leaflet will help you in your decision for treatment. It is intended to give you additional information to that received from the doctors and nurses in the hospital.

Outpatient Medical Management of Miscarriage

We are sorry that your scan has shown that your pregnancy has ended, and a diagnosis of a miscarriage has been made. This is not your fault or your partner’s fault and sadly, about one in four women/people lose their baby in early pregnancy. It may be that you have had very few or no symptoms at all, such as bleeding or pain, but this is not unusual in some types of miscarriage, and you will have been given verbal information on how this treatment works and what to expect. This written information is for you to take home, please keep it somewhere safe, as you may want to look at it over the next few weeks.

Manual Vacuum Aspiration for Miscarriage (MVA)

This leaflet is intended to give you additional information to that received from a healthcare professional. It aims to answer your questions about manual vacuum aspiration, the benefits, risks, alternative treatment options, as well as what you can expect when you come to our hospital for your procedure.

Surgical Management of Miscarriage

SMM is a minor operation that involves removing the pregnancy tissue from your uterus through the vagina. The procedure is done under general anaesthetic and so you will be asleep during the operation. The neck of your womb is gently stretched to allow a plastic suction tube to be inserted into the womb to remove any remaining pregnancy tissue. The operation takes about 10-15 minutes, and you can usually go home on the same day depending on how you feel and if the procedure has been uncomplicated.

Ectopic Pregnancy

An ectopic pregnancy is a pregnancy that develops outside the lining (endometrium) of the womb (uterus). Most ectopic pregnancies occur in the fallopian tube.

Treating Ectopic Pregnancy with Methotrexate

Ectopic pregnancy can be a distressing and frightening experience. This leaflet aims to explain how ectopic pregnancy can be treated with a drug called methotrexate. An ectopic pregnancy is one that develops outside of the womb and can pose significant risk to the mother’s life if it continues to grow. Between 1-2 in 100 pregnancies in the UK are ectopic. Please see the ectopic pregnancy leaflet for more information about ectopic pregnancy, causes and other treatment options.

How to Recover Quickly from Laparoscopic and Robotic-Assisted Surgery

Laparoscopic and Robotic-Assisted Surgery are both forms of minimally invasive surgery laparoscopy (also known as keyhole surgery) offered at Ashford and St Peter’s Hospitals under a general anaesthetic. Usually, three to five small cuts (half to one centimetre in length) are made in the abdomen, allowing your surgeon to insert a small telescope so that they can see inside your abdomen and your reproductive organs directly. Your abdomen will be filled with gas to create space and provide a clear picture and if necessary, to treat any problems as agreed with you before your operation. Before you agree to surgery and sign a consent form, your surgeon will discuss what is planned. This is called informed consent.

Discharge Advice Following Laparoscopic Management of Ectopic Pregnancy

This leaflet provides general information for women going home following a salpingectomy / salpingostomy for an ectopic pregnancy. Please follow any individual advice given on discharge.

How to Prepare for your Procedure with Misoprostol

Misoprostol (Cytotec®) is a medicine used to soften the cervix and make it easier for your procedure to be performed.