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Early Pregnancy Assessment Unit (EPAU)

The Early Pregnancy Assessment Unit (EPAU) is a purpose built unit situated within the antenatal clinic at Macclesfield District General Hospital.

The unit is open five mornings per week Monday – Friday between 8.15 am and 11.00 am. Referrals are received via GPs and midwives following set criteria.

Referral criteria

  • Positive pregnancy test and vaginal bleeding or clinically suspicious of an ectopic pregnancy – up to 14 completed weeks of gestation.
  • Positive pregnancy test and a history of:
  • Ectopic pregnancy
  • Sterilisation
  • Tubal surgery
  • Contraceptive coli insitu 
  • Antiphospholipid syndrome
  • Previous recent attendance at EPAU where condition has changed.
  • Follow-up after medical management of miscarriage, ectopic or termination of pregnancy.

Please note:

Women over 14 weeks gestation who develop a clinical symptom should be referred for an emergency antenatal clinic appointment or for emergency care.

Our services

The EPAU has a lead obstetrician and is run on a daily basis by midwives with the support of maternity care assistants. An ultrasonographer is available during each session.

We offer conservative, medical and surgical management of missed miscarriages providing individualised, informed choice in line with the Royal College of Obstetricians and gynaecologists guidelines. Medical management of ectopic pregnancies is also available to some women.

The staff also offer a listening and support service for women who have suffered a pregnancy loss, to arrange to speak to someone contact 01625 663187 (please note this may be an answer phone so leave a message and the team will get back to you).

Preconception and recurrent miscarriage service

A preconception and recurrent miscarriage service is now available at Macclesfield Hospital and is led by Mr Jyotsna Acharya, Consultant Obstetrician and Gynaecologist. Referral to this service is via your GP.

The preconception service aims to :

  • Optimise maternal health before pregnancy to give the best chance of a successful birth.
  • Target women with pre-existing medical conditions.
  • Provides information to women about how their conditions will affect the pregnancy and how their pregnancy in turn will affect their own health.

This service is in line with national policies such as Maternity Matters, National Service Framework for children,young people and maternity services and Centre for Maternal and Child Enquiries (CEMACH) -Saving mothers lives.

What we offer

The preconception service provides counselling regarding:

  • General preconception eg care planning for pregnancy.
  • Specific obstetric preconception information about, existing medical conditions,recurrent miscarriages or previous obstetric complications.

Examples of conditions 

We see patients with the following conditions:

  • Endocrinology: for example thyroid disorders, diabetes.
  • Neurology: Epilepsy, Multiple Sclerosis, Narcolepsy.
  • Genetics: Cystic Fibrosis,Trisomy and other syndromes.
  • Haematology: Thrombocytopenia, Haemoglobinopathy, Antiphospholipid syndrome.
  • Immunology: Rheumatoid arthritis
  • Respiratory: Asthma
  • Cardiology: Coronary heart disease

Recurrent miscarriages

The recurrent miscarriage element of this service is aimed at patients who have had three or more miscarriages. Patients are investigated to identify possible causes for example genetic factors, medical conditions, uterine abnormalities, infections and maternal age. This service aims to help patients in planning for a future pregnancy by optimising their care from the very beginning ie from the preconception period itself. This service can help many couples who have had recurrent miscarriages still have  a good chance of a successful pregnancy in the future.                           

If you would like any further information then please do not hesitate to contact us:

EPAU Telephone: 01625 663192