Early Pregnancy Assessment Clinic
Who can come to the clinic
Ultrasound appointments are by referral only. Referrals can be made by your GP or out of hours GP, midwife or the Emergency Department (ED).
Positive urine pregnant test and up to 12 weeks pregnant with:
- Abdominal pain
- Vaginal bleeding
- 2 or more previous miscarriages
- Previous ectopic pregnancy
- Previous tubal surgery
- Intrauterine device (coil) in situ
- Persistent vaginal bleeding after surgical management of miscarriage
There are no walk-in slots or self-referrals.
If you are over 14 weeks, you must contact the Maternity Department for advice.
If you have any of the above problems are you are between 12 and 14 weeks pregnant, you will need a referral to the Gynaecology Emergency Clinic or for urgent medical assistance, go to the Emergency Department.
What to Expect when you visit the Early Pregnancy Unit
If you have been referred by your doctor, please bring your referral letter with you to your appointment.
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. 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 transvaginal scans.
Scans are performed by Nurse practitioner or equivalent. There is no doctor routinely present in EPAC. Any patient requiring review by a doctor before or after the ultrasound scan is referred to the Gynaecology Assessment Unit (GAU) or the Gynaecology Emergency Clinic (GEC).
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 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 perform an alternative assessment or blood tests 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 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 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.
You will be given a registration from to complete, including details of your GP. It is often a good idea to have the support of a partner, close friend or relative. However we have limited space in our waiting area, so please only bring one person with you.
Please consider the patients nearby this clinic by keeping noise to a minimum. We also ask that you be considerate of all the others in the waiting room, some of whom may be experiencing pregnancy loss and/or may be feeling unwell.
Please turn your mobile phone off or onto silent. The taking of video recording during the scan is not permitted in our clinic.
Parking: The closest car park to the clinic is Car Park 2, located near the entrance to Green Zone. Please allow sufficient time for parking before your appointment, as there can be queues to await entry.
Smoking: Medway NHS Foundation Trust is a no smoking site
If you have had any tests, we will tell you when you can expect the results. We advise that the contact number you provide us with is one that we can reach you easily. It is important that you respond to our call to prevent a delay in your treatment.
Follow up appointments
After your first visit you may be given a follow-up appointment. If so, please come at the time given to you, so you do not miss your allocated slot. We will try to see you at your appointment time, although delays can sometimes occur.
You need to come to this appointment, even if your symptoms have gone. To discuss any change in your condition or circumstances before your appointment is due, please contact the unit and speak to a nurse.
Other local Early Pregnancy Units
Find a Unit
Early Pregnancy Assessment Clinic (EPAC)
Area 7, Level 2, Green Zone (Opposite Magpies Centre)
Medway Maritime Hospital
Kent ME7 5NY
Tel: 01634 976 229
Monday to Friday: 9am to 4.30pm
If you require urgent medical assistance, please go to the Emergency Department.
Scanning may be available outside these hours and at weekends, but cannot be guaranteed.