title: Primary care follow-up and measured mental health outcomes among women referred for ultrasound assessment of pain and/or bleeding in early pregnancy: a quantitative questionnaire study.
abstract: OBJECTIVE
  To examine the extent of primary care follow-up and mental health outcomes among women referred for ultrasound assessment of pain and/or bleeding in early pregnancy, including those whose pregnancy is found to be viable on ultrasound assessment.
  
  
  METHODS
  Questionnaire study with prospective follow-up.
  
  
  METHODS
  Urgent gynaecology clinic in secondary care, England.
  
  
  METHODS
  57 women participated in the study. Entry criteria: referral to the urgent gynaecology clinic with pain and/or bleeding in early pregnancy; gestation less than 16 weeks (the clinic's own 'cut-off'); no previous attendance at the clinic during the current pregnancy.
  
  
  METHODS
  inability to understand English or to provide informed consent.
  
  
  METHODS
  Incidence of primary care follow-up among women referred to the urgent gynaecology clinic; incidence of women with measured mental health scores suggesting significant symptoms of distress.
  
  
  RESULTS
  Fewer than 1 in 10 women referred for ultrasound assessment of pain and/or bleeding in early pregnancy had follow-up arrangements made with their general practitioner (GP). Most women who had GP follow-up found it helpful and a significant minority of women who did not have GP follow-up felt that it would have been helpful. Following ultrasound assessment, more than one-third of women had significant symptoms of distress. Symptoms of distress, particularly anxiety, were present among those women found to have viable pregnancies, as well as among those with non-viable pregnancies.
  
  
  CONCLUSIONS
  GPs are advised to consider offering follow-up to all women referred for ultrasound assessment of pain and/or bleeding in early pregnancy. Researchers in this area are advised to consider the experiences of women with pain and/or bleeding in early pregnancy whose pregnancies are ultimately found to be viable on ultrasound scan.
authors.affiliation: Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Moscrop
authors.forename: Sian
authors.initials: S
authors.lastname: Harrison
authors.forename: Victoria
authors.initials: V
authors.lastname: Heppell
authors.forename: Carl
authors.initials: C
authors.lastname: Heneghan
authors.forename: Alison
authors.initials: A
authors.lastname: Ward