Emergency Gynaecology Unit (EGU)

Why am I being asked to telephone EGU before attending?

This is so a trained emergency gynaecology nurse can call you back and complete an assessment of your symptoms. Patients with a gynaecological emergency will be asked to attend EGU for a review and assessment, while others may be advised to monitor their symptoms at home under the care of their general practitioner (GP).

What will happen when I arrive at EGU?

On arrival to the department, you will be greeted by a member of the team who will confirm your details for the appointment.  You will then be called into triage and one of our nurses will ask you about your medical history, current symptoms and complete a set of clinical observations (blood pressure, heart rate, temperature, and oxygen levels). They may need to take some blood tests from you, and/or ask you for a urine sample.

EGU is classed as an emergency department (A&E service). Patients are seen in order of clinical priority (where most urgent and life-threatening conditions are treated first) which means patients who arrive in the department after you may be seen before you.

You will be asked to wait in our main waiting area with other patients experiencing gynaecology issues. Please speak to a member of the nursing team if a quiet or private room is required and we will do out best to accommodate.

Following your triage assessment, you will then be asked to wait in the department for an assessment by one of our specialist nurses or doctors. They may need to perform a vaginal or abdominal examination depending on your symptoms.

They may ask further questions about your medical or surgical history to help provide the right treatment. We appreciate this can be stressful and we will endeavour to obtain as much as we can from your hospital records. Sometimes however, we can obtain a better understanding by asking you directly.

Ultrasound Scan Facilities

We have two scan clinics in EGU that run most days except a Saturday.

If you are over 7 weeks pregnant, have not yet had a scan performed in your pregnancy and you are experiencing pain or bleeding, we will try to arrange an urgent scan for you that same day, although this may not always be possible.

If you attend over the weekend or in the evening, your scan will be arranged for the next available appointment, which may be 2-3 days later.

If you are under 7 weeks pregnant it is unlikely that you will receive a scan until your blood pregnancy hormone levels have been established.

If it is necessary for you to have a scan and you are less than 10 weeks pregnant, the scan should be performed vaginally (by inserting a probe) in order to gain the most information.

If you have already had a scan which has shown a viable pregnancy and you experience further pain or bleeding you will be assessed by a nurse or doctor prior to having another scan. If a further scan is indicated this may be arranged for a later date (ie 7-14 days)  in order to allow time for the pregnancy to progress.

If you have already had a scan performed in your pregnancy and you are more than 12 weeks pregnant, we will try to listen to your baby’s heartbeat using a machine.  If for some reason the heartbeat cannot be heard, a scan will be arranged for the next available appointment.

The vaginal probe should not cause any discomfort when used. Before the scan you will be asked to go to the toilet and empty your bladder completely. You will then have to undress from the waist down and lie on a bed with a blanket covering your bottom half.

A condom like cover and sterile lubricating gel are placed over the vaginal probe before it is gently inserted into the vagina. This can contain latex.  We have latex free probe covers and will ask you about any latex sensitivity before we prepare the scan machine.

We have trained sonographers and consultants who perform ultrasound scans within our department. Our consultants can offer you advice and management following your scan. If it is a sonographer carrying out your scan, they will ensure you see a nurse or a doctor to discuss your treatment before leaving the department.

The sonographer scanning you can take a few moments before telling you the results of your scan, this is to ensure they are obtaining the best images and providing you with the correct information. If there are no concerns regarding your pregnancy the sonographer will be able print you out a photograph and show you your baby on the screen.

On some occasions the sonographer may request an additional review of your scan, this may involve a doctor’s review or a re attendance to further monitor the findings.

It is understandable that this could cause you some worry, however, please be reassured this is to ensure you receive the best possible care and we will explain the details of this to you. (See section below on what happens after the scan).

Follow up appointments

In some cases, you may be asked to return for repeat blood tests or scans. You will be given an appointment time for this.

Please note that whilst we make every effort to see you at your appointed time, it is not always possible if there are unwell or upset patients who need to be seen urgently.

Where is the EGU located?

EGU is located at Wythenshawe Hospital on ward f16. Accessible via entrance 15 and is on the first floor.

How do I get an EGU Appointment?

• Self-referral by telephone assessment on 0161 291 2561

• Ultrasound scanning appointment times are from 8am – 4pm Monday – Friday and Sunday 08:30am-11:30am, you will be offered the next available appointment time.

• We aim to offer an ultrasound scan within 72 hours of referral.

Can I bring someone with me to my appointment?

You are welcome to bring your partner or a friend/relative.

Please note that due to the size of some of our rooms we may ask for only one person to accompany you during your appointment.

We advise you to make alternative arrangements for children however we do appreciate this is not always possible. If you are unable to arrange childcare, please be aware you are responsible for the safety of your children at all times.

Will the scan harm my baby?

A transvaginal scan will not harm your baby or cause you to miscarry.

Do you need to drink plenty of fluids before your scan?

No, for an internal scan we need an empty bladder, you will be asked to use the toilet before your scan.

Can an internal scan still be done if the patient is bleeding?

Yes, we can still scan you if you are bleeding, we are used to scanning patients who are bleeding in early pregnancy, please do not worry about this.

What will happen after the scan?

 The following are likely outcomes.

• We see a pregnancy with a heartbeat, and we can discharge you.
• We see a very early pregnancy before the heartbeat stage, and we offer to re scan you in 1-2 weeks to ensure that the pregnancy is progressing ok.

However, there are several reasons why we may not see a pregnancy on your first visit.

• It is too early in the pregnancy to see the baby on ultrasound scan.
• The pregnancy is not growing as it should.
• Some patients who visit the EGU will be diagnosed with a miscarriage or ectopic pregnancy, and they will need further treatment and possibly an admission to hospital.
• We may not see a pregnancy on the scan, either inside or outside of the womb. If your pregnancy test is still positive, we will advise we do a blood test to monitor your pregnancy hormone also known as bHCG Level. The reasons of this will be explained further at your appointment.

However- If you experience any of the following:

• New or increasing pain
• Increased levels of Bleeding – soaked sanitary towel every 30 -60 mins.
• Shoulder tip pain
• Diarrhoea and/or vomiting.
• New dizziness on standing.

Please call us on 0161 291 2965 for further assessment.