Abstract
Background
Women experiencing bleeding in early pregnancy suffer considerable anxiety. Waiting for a considerable time for a diagnosis adds to their grievance. Early Pregnancy Assessment Unit (EPAU) is a dedicated service that provides quick and easy accessibility to diagnosis, treatment and support service.
Aim
To monitor the first 6 months of the EPAU service in the Rotunda Hospital, to identify its shortcomings, so that we can ensure effective EPAU care in future.
Methods
A retrospective audit between July and December 2002 was performed.
Results
A majority of patients (83.4%) were self-referrals. All patients were seen between 1 and 3 h. In the miscarriage group, 218/278 (78.4%) was managed surgically by evacuation and a further 60/278 (21.6%) received conservative or medical treatment. Among 13 ectopic pregnancies, 5/13 (39%) had laparoscopic management.
Conclusion
This clinic has enabled us to manage early pregnancy bleeding in an effective manner within a satisfactory time period. The high surgical intervention rate for miscarriages is highlighted to support the need for greater emphasis on medical and expectant management.
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References
Alberman E (1992) Spontaneous abortion: epidemiology. In: Stabile S, Grudzinkas G, Chard T (eds) Spontaneous abortion: diagnosis and treatment. Springer, London, pp 9–20
Bradley E, Hamilton-Fairley D (1998) Managing miscarriage in early pregnancy assessment units. Hosp Med 59(6):451–456
Thaper AK, Thapar A (1992) Psychological sequelae of miscarriage: a controlled study using the general health questionnaire and the hospital depression and anxiety scale. Br J Gen Pract 42(356):94–96
Hopper E (1997) Psychological consequences of early pregnancy loss. In: Grudzinskas JG, O’Brien PMS (eds) Problems in early pregnancy: advances in diagnosis and management. RCOG Press, London, pp 296–308
Moulder C (1995) Guidelines for good practice. In: Miscarriage women’s experiences and needs, 2nd edn. Harper Collins, London, pp 253–263
Bigrigg MA, Read MD (1991) Management of women referred to early pregnancy assessment unit: care and cost effectiveness. BMJ 302(6776):577–579
Fox R, Richardson J, Sharma A (2000) Early pregnancy assessment. Obstet Gynaecol 2(2):7–12
Walker JJ, Shillito J (1997) Early pregnancy assessment units: service and organisational aspects. In: Grudzinskas JG, O’Brien PMS (eds) Problems in early pregnancy: advances in diagnosis and management. RCOG Press, London, pp 160–173
Li TC, Tristram A, Hill AS, Cooke ID (1991) A review of 254 ectopic pregnancies in a teaching hospital in the Trent region. Hum Reprod 6:1002–1007
Hinshaw HKS (1997) Medical management of miscarriage. In: Grudzinskas JG, O’Brien PMS (eds) Problems in early pregnancy: advances in diagnosis and management. RCOG Press, London, pp 284–295
Henshaw RC, Cooper K, el-Refaey H, Smith NC, Templeton AA (1993) Medical management of miscarriage: non-surgical uterine evacuation of incomplete and inevitable spontaneous abortion. BMJ 306(6882):894–895
Bauman R, Magos A L, Turnbull A (1991) Prospective comparison of videopelviscopy with laparotomy for ectopic pregnancy. Br J Obstet Gynaecol 98:765–771
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Akhter, P., Padmanabhan, A., Babiker, W. et al. Introduction of an early pregnancy assessment unit: audit on the first 6 months of service. Ir J Med Sci 176, 23–26 (2007). https://doi.org/10.1007/s11845-007-0013-2
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DOI: https://doi.org/10.1007/s11845-007-0013-2