Our miscarriage clinics provide all the services concerned with the investigation and treatment of recurrent pregnancy loss. It also supports women throughout the early stages of their pregnancies.
We accept referrals for patients who have experienced three or more consecutive early pregnancy losses (less than 14 weeks)
We accept referrals for patients who have experienced two consecutive pregnancy losses where;
i). The patient is over 35 years or
ii). One of these two losses occurred in the second trimester (measured over 14 weeks).
We accept referrals for patients who have been advised by a specialist that transabdominal cerclage may help them in a future pregnancy. For example women who have had previous extensive cervical surgery or those for whom a vaginal cerclage would not be possible or has not been successful in the past.
We accept referrals for patients who have experienced three or more consecutive early pregnancy losses (less than 14 weeks)
We accept referrals for patients who have experienced two consecutive pregnancy losses where;
i). The patient is over 35 years or
ii). One of these two losses occurred in the second trimester (measured over 14 weeks).
What will happen?
At a first visit to the clinic, which takes on average 40 minutes, a wide variety of diagnostic investigations are needed to screen for the possible causes of recurrent miscarriage. All patients referred to the clinic have blood tests for a range of screens including blood count, thyroid function and levels of antibodies.
The specialist miscarriage nurse you meet at your first appointment will take your history and explain the blood tests. Vaginal swabs are also taken for patients whose history warrants them. Patients who suffer a pregnancy loss during the second trimester are arranged a 3D ultrasound scan and vaginal swabs for bacterial vaginosis and cervical chlamydia. For more information about the tests and treatments that take place in the miscarriage clinic, please visit our patient information section.
**Please avoid pregnancy if possible before being seen at your first appointment, should you become pregnant before your appointment please contact EPAU**
At a second appointment, six to eight weeks later, one of our consultants will discuss the results with you and a future plan.
Care in pregnancy
We offer access to pregnancy surveillance for two years after the most recent review appointment. These appointments are to allow reviews and ultrasound in early pregnancy with a member of the team tailored to the client’s history. If you are pregnant more than 2 years from your last appointment please contact your GP to arrange an urgent referral.
Our pregnancy support midwife sees patients over 12 week’s gestation on a Wednesday and liaises closely with Consultant-led antenatal care located at Liverpool Women’s and Aintree Centre for Women’s health. For patients who have experienced late pregnancy loss or have required a cervical cerclage we arrange ongoing pregnancy care with the Harris preterm labour clinic at Liverpool Women’s where appropriate.
Support
We liaise with the Honeysuckle team for bereavement support. Clients are also signposted to local counselling services were needed, although we currently do not receive any direct funding. The miscarriage association also provides support services and useful resources.
Research
The recurrent miscarriage clinic and early pregnancy service at Liverpool Women’s offers Clients the opportunity to become involved with national research studies related to early pregnancy loss. Recent examples include TABLET, PRISM and PROMISE. ALIFE 2 has recently closed to recruitment and results are awaited. We are currently actively recruiting to CERM (Chronic Endometritis and Recurrent Miscarriage). For latest details of studies we are recruiting to please contact the Research Team.
Location & clinic times
The nurse-led history and screening outpatient clinic is usually held on Thursday between 9am and 12.30pm.
The consultant-led outpatient clinics are held at Liverpool Women’s every Thursday between 1.30pm and 5pm. Consultant and Nurse Led Pregnancy surveillance clinics offer support in early pregnancy on a Monday and Tuesday morning.
Pregnancy support booking appointments are usually on a Wednesday morning and follow up antenatal care is arranged after this.
Contact us
If you need to rearrange or cancel your appointment, please contact outpatients on 0151 702 4352 or 0151 702 4328, between 8.30am and 4.30pm, Monday to Friday. An answer machine is available out of hours. If you require any clinical information about your outpatients’ appointment please ring 0151 708 9988 ext: 4617.
Meet the team
Annmaria Ellard is our specialist nurse, with over 20 years’ experience in recurrent miscarriage and early pregnancy care. Annmaria was recently nominated for and won a Tommy’s award for patient care.
Dr Linda Watkins is the Lead clinician. She has been a Consultant in Obstetrics at Liverpool women’s for thirteen years and has an interest in early pregnancy care, preterm birth and recurrent miscarriage. She is the principle investigator for the trust for several recent studies.
Dr Katerina Bambang is a consultant Gynaecologist and subspecialist in Reproductive medicine. She has an interest in fertility preservation. She holds a PhD in Recurrent miscarriage and is currently developing the research portfolio for recurrent miscarriage at Liverpool Women’s.
Ms Manou Kaur is a consultant Gynecologist who specialises in complex laparoscopic surgery. She leads Liverpool Women’s robotic laparoscopic transabdominal cerclage service.