Early Pregnancy Assessment Clinics (EPAC)
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.
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.