Pain and Bleeding in early pregnancy
The Elizabeth Suite
In the Elizabeth Suite—our Early Pregnancy and Acute Gynaecology Unit (EPAG)—we see and look after women who are referred to us in the early stages of pregnancy (under 20 weeks gestation) and those with gynaecology emergencies.
All women seen for the first time in the unit require a referral from their GP or healthcare professional. We are not able to accept self-referrals or walk-ins. Once we have received your early pregnancy referral we aim to see you within 24 hours. We see many patients on the same day that they are referred.
Bleeding and Pain in Early Pregnancy
Bleeding and pain in early pregnancy can be distressing but doesn’t always mean that there is a problem. However sometimes it can be an indication of a miscarriage or other early complications in pregnancy.
Bleeding in early pregnancy may be:
- Normal (implantation bleed)
- A sign of a miscarriage
- Subchorionic haematoma
- An ectopic pregnancy
- A pregnancy of unknown location
- Molar pregnancy
- Of unknown cause
What to do if you have bleeding
If you have mild to moderate bleeding or pain, contact your GP or other healthcare professional looking after you (eg midwife, Assisted Conception Unit nurse) who will refer you to our unit. However, if you have:
- Heavy bleeding
- Severe pain
- Feel dizzy or unwell
Please make your way to the closest emergency department (see section below ‘When to attend the Emergency Department’).
We advise that you use a sanitary pad and avoid using tampons. You can take paracetamol for pain relief if required.
Your appointment
At your appointment you will be seen by one of our specialist nurses, sonographers or doctors.
You may wish to bring along your partner, a relative or friend to the appointment. We ask that only one adult attends the consultation with you.
Within The Elizabeth Suite we try to maintain a calm atmosphere for patients. For this reason we ask that you try to arrange alternative childcare for any young children or babies when visiting the unit.
You will be asked about your symptoms and your medical history. A vaginal examination may be carried out to assess your symptoms. You may be offered an ultrasound to assess the pregnancy.
It isn’t always possible to give you a clear answer as to what is happening with the pregnancy at the appointment. Sometimes we need to arrange further scans or perform blood tests.
Scans
The majority of the scans performed in the unit are done via a ‘transvaginal’ approach. This means the tip of the ultrasound probe is passed into the vagina.
It is not in any way damaging to a developing pregnancy and should not be painful, although some women experience slight discomfort. This scan can be done even if you are experiencing bleeding.
- Women who are not pregnant or who are less than 12 weeks pregnant will be asked to pass urine before the scan, as your bladder must be empty.
- Women who are more than 12 weeks pregnant will usually be scanned on your tummy (transabdominal), which requires your bladder to be full.
When to attend the Emergency department (ED)
If either before or after your appointment with us you experience any of the following we would recommend you present yourself to ED.
- If your bleeding is heavy and continuous, for example if you are soaking more than two large sanitary pads an hour for 4 hours or more or passing large clots (golf ball size or larger)
- If you have severe pain in your abdomen or pain in your shoulder
- Feel faint/dizzy or unwell
After your appointment
You will be given our contact details so you are able to call for blood test results or if you have any questions or concerns.
Our clinics are busy so we kindly advise you to please use the telephone number that applies to your query.
Early Pregnancy and Acute Gynaecology Unit (EPAG)
For further support when you are at home, contact your GP or call the specialist nurse.
Contact information
The Elizabeth Suite
Early Pregnancy and Acute Gynaecology Unit
4th Floor, Lift Bank B
T: 020 3315 5073 (admin queries only 9-12pm & 2-4pm Mon-Fri)
T: 020 3315 5070 (clinical queries only 12-2pm Mon-Fri).
Useful information
W: www.ectopic.org.uk