Emergency Gynaecology Services

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).

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, respiratory rate, temperature, and oxygen levels). They may need to take some blood tests from you, and/or ask you for a urine sample.

As an emergency 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 our 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.

You are welcome to bring your partner or a friend/relative. Please note that due to the size our waiting rooms we ask for only one person to accompany you.

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.

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.

• EGU ultrasound scan appointment times are from 08:00 – 16:00 Monday – Friday and Sunday 08:30am-11:30am. Please note EGU does not have ultrasound appointments on a Saturday.
• GAU ultrasound scan appointment times are from 08:50 – 16:00 Monday – Friday. Please note GAU does not have ultrasound appointments on a Saturday or Sunday.

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.

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, this is to ensure they are obtaining the best images.

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.

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

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

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

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.
• 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.
• Some patients will be diagnosed with a miscarriage or ectopic pregnancy, and they will need further treatment and possibly an admission to hospital.