Introduction of an early pregnancy assessment unit: audit on the first 6 months of service.
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.


OBJECTIVE
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.


CONCLUSIONS
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.
Akhter
P
P
Department of Obstetrics and Gynaecology, The Rotunda Hospital, Parnell Street, Dublin 1, Ireland. binduakhter@hotmail.com
Padmanabhan
A
A
Babiker
W
W
Sayed
A
A
Molelekwa
V
V
Geary
M
M
D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008485:Medical Audit; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011271:Pregnancy, Ectopic / Q000175:diagnosis*; D012189:Retrospective Studies; D013997:Time Factors; D016387:Women's Health