Early Pregnancy Assessment Clinic

What to expect when you visit the Early Pregnancy Assessment Clinic (EPAC)

We understand that if you attend the clinic with pain or bleeding in the early stages of pregnancy that you will be anxious and worried. We are here to support you during this time and to provide you with advice.

If you have been referred to the clinic by your GP, please ensure you bring your referral letter to your appointment.

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.

Ultrasound scans done before 12-weeks are usually internal (vaginal) as they give us a clearer, more defined image enabling an accurate diagnosis. This is a safe procedure which should not be painful. You will be asked to empty your bladder for an internal scan.

Scans are performed by a nurse/midwife practitioner or equivalent. Should you need to be reviewed by a doctor before or after the ultrasound scan you will be referred to the Gynaecology Assessment Unit (GAU).

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

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 an ultrasound scan in early pregnancy. When scans are performed for reassurance, we would recommend that you are at least six-weeks from your last period date in so we can see a fetal heartbeat. If you are less than six weeks, we may perform an alternative assessment or blood test before we arrange 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 a 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 Emergency Department if your symptoms worsen in the interim. In some cases, it is more practical to monitor your hormone levels at intervals in order to see a pattern. 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.