Pain and bleeding at <12 weeks in pregnancy

Who can refer:

Appointments Only (Patient needs to phone the department to be triaged and given an appointment, they should not present in person) 

• Self-referral
• GP 

• Practice Nurse 
• Health Visitor 
• Midwife 

Who to refer:

• All pregnant patients at less than 12 weeks gestation with pain or bleeding (including those with suspected ectopic pregnancy). 
• Reassurance USS is available for patients who have had: 
  • Previous ectopic pregnancy- USS at 6+2/40 
  • Previous molar pregnancy 

We are unable to offer reassurance USS to patients who have had previous miscarriages at this time. 

Who not to refer:

Patients with hyperemesis should be referred to obstetric triage. 

How to refer:

(e.g. SCI & which option etc)  

We operate an appointment system. Please do not send patients up without having spoken to a member of the nursing staff. Please advise patients that they may not be seen face to face at initial contact but will be triaged and followed up appropriately. 

RIE: 0131 242-2438 or 0131 242-2425 

SJH: 01506 524 015 

Out of hours: Contact Gynaecology registrar on call through appropriate switchboards (GP referral only). 

You will be asked to provide the following info when contacting PSC/EPU (they will then not require a referral letter from you): 

• LMP 
• Date of first positive test 
• Menstrual cycle length  
• Full medical history  
    

Following telephone discussion, we often request that a baseline hCG be taken in the surgery and PSC/EPU will then chase the result and call the patient with a management plan.  
  
We may ask patients to have follow up hCG taken in their surgery and PSC/EPU will chase the result and call the patient with a management plan