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Early Pregnancy Unit (EPU)

The Early Pregnancy Unit (EPU) provides assessment, ultrasound scans and treatment for women and birthing people up to 16 weeks pregnant who have concerns such as vaginal bleeding, abdominal pain, or a history of early pregnancy complications. The EPU is staffed by specialist nurses and doctors. We take pride in providing prompt, kind and compassionate care.

The EPU is open Monday to Friday from 9am to 4pm. We are an appointment-only service and do not accept walk-ins. Please note that we give priority to those who are seriously unwell so you may have to wait after your appointment time if we have to deal with an emergency.

How to refer

We accept self-referrals and referrals from GPs, midwives, private hospitals and termination services.

If you have pain, bleeding or other concerns (such as previous miscarriage or past ectopic pregnancy) and do not have any of the red-flag symptoms below, you can self-refer to the EPU by completing our Early Pregnancy Unit referral form.

Bromley GPs should use the Referrals Optimisation Tool to refer patients to these services. GPs from other boroughs, and other health professionals, should complete our Early Pregnancy Unit referral form.

Our EPU team aims to respond by 4pm on the next working day to arrange an appointment.

When to seek urgent help?

Please do not wait for an EPU appointment if you experience any of the following red-flag symptoms:

  • heavy vaginal bleeding (soaking two or more sanitary pads per hour)
  • passing large clots or pregnancy tissue
  • sudden or severe abdominal or pelvic pain
  • pain in your shoulder tip
  • dizziness, fainting or collapse
  • fever, chills or generally feeling unwell

If any of these occur, go immediately to your nearest Emergency Department, call 999, or contact your GP for urgent medical advice.

If you are unsure whether to attend A&E or self-refer, please call NHS 111 for guidance.

What to expect when you are assessed

A doctor or a nurse will assess you by taking your medical history. You will also have an internal ultrasound scan. They will then discuss with you the likely cause of your symptoms, whether you need to have any more investigations, and your treatment options. You are welcome to bring along a companion for this appointment.

Frequently asked questions (FAQs)

Is the scan safe?

The scan uses soundwaves for a short time, and this has been found to be safe in pregnancy.

What are you assessing for with the scan?

We are looking for signs of a pregnancy (for example, a baby, pregnancy sac), its location, the number of babies, and if there is a heartbeat. We will also look at the areas beside the womb, and this enables us to assess the ovaries. It is not unusual to find a cyst relating to the pregnancy.

How long will the internal scan take?

The internal scan takes a few minutes. However, a second opinion is occasionally needed where another clinician attends and may ask to repeat the scan. This should be explained to you at the time.

Is the internal scan painful and is it my only option?

An internal scan needs the probe to be placed in the vagina, with an empty bladder. This should not be painful, and the clinician will stop when asked to do so or if they have any concerns. The alternative to an internal scan is an abdominal scan, when the probe is placed over the skin of the tummy and may require a partially full bladder. This is not as accurate as the internal scan for seeing very early pregnancy problems.

Treatment

Treatments available for miscarriage include: day surgery treatment under general anaesthetic, surgical management under local anaesthetic, outpatient medical management, and natural management.

Treatments available for ectopic pregnancies include: laparoscopic surgery, medical treatment with methotrexate, or natural management.

Pregnancy remains

Staff will explain the options that are available to you for your pregnancy remains and will support you in whatever decision you make. All pregnancy remains will be treated and managed by the hospital in a lawful and respectful way. This will be done on our wards, in the histopathology department and in the mortuary. Please accept our sympathies at this difficult time – we are here to support you as much as possible.

Please note that pregnancy remains are cremated at Eltham Crematorium should you wish to visit their garden of remembrance.

Contact details

Outpatients C, Level 1, South Wing, Princess Royal University Hospital, Farnborough Common, Orpington, Kent BR6 8ND

Tel: 01689 865721

Email: kch-tr.pruhepagsu@nhs.net

Further advice and support

A number of organisations give dedicated support and advice to people affected by issues such as miscarriage and baby loss:

Patient information leaflets