Early Pregnancy Assessment Clinics (EPAC)

Coronavirus (COVID-19): Early Pregnancy Assesment Clinc

At North Bristol Trust’s Early Pregnancy Clinic we have actively taken measures to reduce the risk of spreading Coronovirus (COVID-19) to protect all our patients and staff from the risk of infection.

From 31 March: 

  • We will reduce face to face clinic appointments. 
  • You first consultation with one of our experienced early pregnancy team will be via  telephone.
  • If you need to attend the clinic for an ultrasound scan you will be given a time to attend.
  • If you are required to attend the clinic in person, we would ask you to inform us if you have any symptoms of a high temperature or a continuous new cough, or if any of your family members are unwell or are self-isolating for any reason.
  • Please note, you will not be able to have any partners or family coming into the clinic.
  • We are to make changes to the way we can follow up some women.

To contact the Early Pregnancy Clinic, please telephone 0117 4146778 and leave your name and telephone number. We will call you back as soon as possible.

If you require emergency medical assistance please contact NHS 111 or in an emergency dial 999 or attend the Emergency Department – for example very heavy bleeding, severe pain.

The safety of our women is our number one priority. We appreciate your patience and understanding.

The Early Pregnancy Assessment Clinic (EPAC) is an emergency service available to all women referred by their GP or Health Professional. 

EPAC at Southmead Hospital accepts women who are experiencing pain and/or bleeding between 6 and 18 weeks of their pregnancy and sees over 5000 emergency patients each year. 

Women must be referred to the clinic – it is not a drop-in service.

The clinic accepts referrals between 8.30am and 11am Monday to Friday. Scanning starts at 9am. 

Patients are seen in order of arrival and it is difficult to know how many women will attend each day. Waiting times at the clinic vary and may result in a 2-4 hour wait in total.

Guidelines for Referral

  • A positive pregnancy test is mandatory (either GP or home test)
  • Early pregnancy more than 6+0 weeks and fewer than 18+0 weeks from LMP
  • Early pregnancy bleeding and/or pain
    (If booked at a hospital, the patient should be referred to their hospital of booking)
  • Previous ectopic or molar pregnancy (above 6 weeks gestation)
  • If a woman has pain between 5 and 6 weeks gestation a referral will be accepted but the patient may not be appropriate for a scan. It is important to be aware of this.

Pregnant women with viable pregnancies are discharged and if they have further problems would need to be re referred to the clinic.

Management of miscarriage
EPAC at Southmead Hospital offers a choice of treatment following diagnosis of a miscarriage: Conservative management; medical management; surgical management under local anaesthetic (MVA) and surgical management under a general anaesthetic.

Ectopic pregnancy
Treatment varies between conservative, medical and surgical management.

Current Anti D guidelines
Anti D 500 IU is recommended for all rhesus negative women with vaginal bleeding after 12 weeks of pregnancy. If bleeding continues intermittently, Anti D 500 IU is repeated after 6 weeks. If bleeding is heavy or there is significant pain, Anti D 500 IU is repeated after 2 weeks.