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Early Pregnancy Assessment Unit (EPAU)

There are over 200 Early Pregnancy Assessment Units (EPAU) across the UK in NHS hospitals, and we are lucky to have a dedicated EPAU here at Liverpool Women’s Hospital. EPAU is a specialist unit that provides care for women with problems in early pregnancy (6-12 weeks).

The most common reasons women are referred to our EPAU are:

  • Bleeding and/or pain with a positive pregnancy test
  • Women with previous ectopic pregnancy
  • 2 consecutive miscarriages in the preceding pregnancies
  • For specialist care if a problem is suspected after an early pregnancy ultrasound scan in another setting

The unit is staffed by specialist nurses with access to doctors.

  • We only perform Trans-vaginal ultrasound scans in EPAU
  • This scan does not cause harm to the pregnancy
  • This scan does not require a full bladder

The scan allows for closer examination of the pelvic organs (the womb, tubes and ovaries) which has an advantage if it is a very early pregnancy or an ectopic pregnancy is suspected. Abdominal scans in early pregnancy can be limited and possibly delay diagnosis. 

If you have an on-going pregnancy you will be advised to arrange your Antenatal care via the access centre here at Liverpool Women's Hospital on 0151-702-4352 (Option 1). 

However, there are a number of reasons why it may not be possible to interpret the scan results on your first visit. You may hear the term PUL (pregnancy of unknown location) used in this situation.

  • It is too early in the pregnancy to see the baby on ultrasound scan
  • The pregnancy is not growing as it should
  • The pregnancy may be growing outside of the womb
  • This is known as an ectopic pregnancy

You may require more than one scan and a series of blood tests in order to confirm what is happening with the pregnancy. The frequency and timing of the scans will depend upon how far pregnant you are and what the initial scan shows. Understandably you will be anxious about your pregnancy but more scans or changing the frequency of the scans will not help the diagnosis to be reached sooner. Be guided by the staff caring for you as to how many scans are required

How to access EPAU

  • Assessment is by appointment ONLY
  • Ultrasound scanning appointment times are from 8am – 4pm on weekdays, you will be offered the next available appointment time.
  • We aim to offer an ultrasound scan within 72 hours of referral
  • Access is via:
    • Self-referral by telephone assessment on 0151 702 4140
    • Clinical assessment in the Emergency Department
  • EPAU is located on the ground floor via the entrance to Gynaecology Emergency Department (GED).

Reassurance Scans

These scans are not an emergency and the staff will offer a scan time at the earliest opportunity once they have taken your history. Staff will happily arrange a reassurance USS for you only if you fulfil the following criteria:

  • Have a positive pregnancy test and are 7 weeks from your last period
  • Have experienced two consecutive miscarriages in your last two pregnancies or
  • Have experienced an ectopic pregnancy

If you have had a miscarriage and then a normal pregnancy, we are sorry but we are unable to offer a reassurance scan. We are only able to offer one scan for reassurance. Private scan facilities are available in the imaging department – please ring: 0151 702 4483.

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