Early Pregnancy Unit (EPU)

At the unit

We aim to see patients within four hours of arriving on the unit.

Patients are asked to give a urine sample and their blood pressure and temperature will be checked. Our nurse co-ordinator will ask some questions about the situation and get a medical history to make sure or patients are in the right department for their needs. 

The specialist gynaecology nurse will ask you about the problem and perform any necessary series of investigations before a final diagnosis is made, e.g. patients may be offered an ultrasound, if appropriate or a listen of the baby’s heart beat if over 12 weeks; and may have a vaginal examination and/or blood tests.

Our patients may then:

• Be referred to another member of staff or for tests
• Be able to safely go home
• Have a follow-up appointment arranged at the unit
• Have a phone call arranged for their test results and advised when next to attend for more blood tests or for a scan
• Be asked to stay in hospital for monitoring 

When you attend hospital with pain or bleeding in early pregnancy, we understand that you are anxious and worried about whether or not your pregnancy will continue. We want to support you during this stressful and worrying time and are here to listen and advise you.

Once we have discussed your individual situation and obtained a history of all your relevant medical information, we are then able to plan your further assessment and treatment with you.

Many women attend hospital expecting to have an ultrasound scan. This may not always be available at the time of their visit. Independent Ultrasound scanning requires extensive training and expertise which may not always be available outside of normal working hours.

Ultrasound scans, done before 10 weeks, are usually internal (vaginal) as they give us a clearer, more defined image enabling an accurate diagnosis. You will be asked to empty your bladder for vaginal scans. These scans may be performed by a Doctor, Sonographer or Nurse.

The timing of the scan is important to enable us make an accurate diagnosis, especially in the early weeks of pregnancy. If done too early, then we may not be able to tell you if you have a viable pregnancy, confirm a miscarriage or exclude an ectopic pregnancy (tubal).

As pregnancies can be conceived at any point in your cycle, a week or two can make a huge difference to what we see on ultrasound scan in early pregnancy. When scans are performed for reassurance, we would recommend that you are at least 6 weeks from your last period date in order that we can see a fetal heartbeat. If you are less than 6 weeks, we may do blood tests initially to check your pregnancy hormones (hCG) to confirm you are far enough into your pregnancy, for us to be able to perform an ultrasound scan.

If you experience pain in early pregnancy, an ectopic pregnancy needs to be considered as a possible diagnosis. We may need to perform as series of investigations before a final diagnosis is made. Ectopic pregnancies occur most commonly in the Fallopian tubes. The diagnosis may not always be made at your first visit. You will be advised by the clinic staff of the most appropriate steps to take pending a definite diagnosis. This may include attending the A&E department if your symptoms worsen in the interim. In some cases, it is more practical to monitor your hormone levels at 48 hourly intervals in order to see a pattern. Patients whose hormone levels double are more likely to have viable pregnancies compared to those whose hormone levels show little change in values. We will always inform you of your results by telephone and advise you when next to attend for more blood tests or for a scan.

If you require repeat scans, we would usually recommend that this is done a week or two after the first scan. This is because we want to be sure we are able to detect significant changes in the development of your pregnancy.  Please remember that we are here to help and support you in making decisions.

If you are further on in your pregnancy and over 12 weeks, we may invite you in for your baby’s heart to be heard on a hand held-machine called a Sonicaid ™, rather than perform a scan. The EPU staff will arrange for you to attend. Hearing your baby’s heart beat is very reassuring, especially when you are yet to feel movements.

Please remember that the early pregnancy unit staff are always happy to be contacted to discuss any concerns you may have. Please do not hesitate to call us.

• Queen Elizabeth Hospital - EPU department is open weekdays from 9-12pm on a referral basis only.
• Princess Royal University Hospital (PRUH) - EPU is open Monday to Friday from 9-12pm on a referral basis only.
• Pembury/ Tunbridge Wells Hospital - EPU is open Monday to Friday 7am-8pm/ referral basis only. They will also open on Saturdays if closed on Bank Holiday Monday.
• Medway Hospital - EPU is open Monday to Friday 9.30 to 3.30 on a referral basis only. Also open on occasional Saturdays.