Procedures for threatened miscarriage (FOI)

​​Request

I would like to see the policies and procedures for A&E when a pregnant woman presents with pain & bleeding, threatened miscarriage, outside of office hours (rayner and EPAU closed)

Response

As noted in a Freedom of Information response published to www.gov.je in October 2024:

‘Pregnant women presenting to the Emergency Department (ED) outside of Rayner Outpatients operating hours will be reviewed of their symptoms by the clinical team. 

If pregnant and clinically stable, they will be referred to the Early Pregnancy Assessment Unit (EPAU) for review and scan, usually within 24 hours. If attending over a weekend, scanning will be performed on the next Monday, with a safety net to attend ED if bleeding or pain increases. 

If the person attending is clinically unwell, they will be admitted and the on-call consultant will proceed to perform a scan and make a decision for treatment based on the results. Obstetrics and Gynaecology Consultants are competent in early pregnancy scanning and will provide out-of-hours scans if clinically indicated, as necessary.’

The full response can be found at the following link:

Out of hours policy for first trimester scans (FOI)​

The Gynaecology Admissions Pathway for acute gynaecology and early pregnancy referrals includes a General Practitioner (GP) pathway and an Emergency Department (ED) pathway, including for those attending ED outside of the outpatient service operating hours. 

The existing ED pathway is attached. This is currently being reviewed and updated following the appointment of a new Clinical Lead for the Early Pregnancy Assessment Unit (EPAU).

Gynaecology Admissions Pathway - ED Pathway.pdf​

​This pathway is shared with ED and Gynaecology service colleagues. The ED pathway is also available in the MicroGuide application used by doctors.