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Contact: Box 229, Tel: 01223 217 636 or 217 637; Fax:
01223 256 244
The Daphne Ward is a rapid-referral ward for women
experiencing problems in early pregnancy or emergency gynaecological
conditions.
Open: Monday to Friday: 0800 to 200 hrs (last admission
accepted at 1800 hrs - after this, patients are seen on Ward D6,
which is the main gynaecology ward).
(1) The Early Pregnancy Unit
and Emergency Gynaecology Assessment Unit
The Early Pregnancy Unit (EPU) offers assessment
for women who are in the first 13 weeks of pregnancy. Women attend
The Unit with pregnancy-related problems such as per vaginal (pv)
bleeding and/or pain.
Women can telephone the Unit and seek advice from
one of the Gynaecology nurses. If required, an ultrasound scan
will be organised, for the next available EPU scan list in the
Rosie ultrasound scan department. Once scanned, patients are reviewed
on Daphne ward by Gynaecology nurses and/or medical staff.
Most women leave the Hospital, reassured by the
scan. Blood samples can be taken from those women who are over
12 weeks of pregnancy to assess their rhesus status, and they
can be given anti-D immunoglobulin (to prevent rhesus disease),
if required.
If necessary, some women will be offered a clinical
examination by a doctor. This is required if there is any question
that the pregnancy might not be in the right place (ie an ectopic
pregnancy) or if the ultrasound scan is unable to confirm this
because it is too early. These women may be offered blood tests
to check the levels of the pregnancy hormone, beta human chorionic
gonadotrophin (ßhCG) in their bloodstream.
Support in the Early Pregnancy Unit
Some women attending The Unit will be miscarrying,
and The Unit is able to offer surgical, medical and conservative
(non-surgical) management. Full details will be given to help
you decide which is most appropriate for you. Women who prefer
to be managed surgically are usually offered a place on the operating
list in the Day Surgery Unit, which takes place every Monday morning.
This operation is known as an ERPOC (evacuation of retained products
of conception).
Following the procedure, women will be free to leave
the Hospital after a few hours (after being discharged by the
nursing staff), providing they are well enough (and the discharge
criteria have been met).
Medical management of miscarriage involves having
medication to induce the miscarriage, and this is a two-part procedure
performed over a 48-hour period. First, drugs are given by mouth
and, usually after half an hour, the woman goes home. She will
need to return 48 hours later for the second part of the procedure.
The woman is admitted for the day, and the second dose of drugs
are given vaginally. Most of these women miscarry while they remain
in hospital, but some will do so at home.
During the treatment, women have open access to
The Unit and also to Ward D6 (the main Gynaecology ward) in case
of emergency or if they require any advice.
Women who prefer to manage their miscarriage conservatively
(without surgery) can go home after having a discussion with the
Gynaecology nursing staff and/or the medical staff. Such women
can then wait for up to 10 days for the miscarriage to occur without
medical intervention, during which time they have open access
to The Unit and ward D6 either in case of emergency or if they
require any advice.
If, after 10 days, the miscarriage has not completed
naturally, the Gynaecology nursing staff will discuss on the telephone
with the woman if she would prefer medical or surgical intervention,
to help with the miscarriage.
The Emergency Gynaecology Assessment Unit
The Emergency Gynaecology Assessment Unit works
closely with the Early Pregnancy Unit and offers assessment by
medical staff up until 2000 hrs at night.
Patients need to be referred into the Unit via their
GP, who can either contact the on-call senior registrar, or refer
them directly to The Unit. The Unit sees patients with any gynaecological
emergency and, following assessment, those patients needing inpatient
management are transferred to Ward D6, the main gynaecology ward.
For referring doctors or midwives only: Women
who have a positive pregnancy test (with or without pain or bleeding),
or women who have known risk factors for an ectopic pregnancy,
can be referred directly by their GPs or midwife to the Daphne
Ward at the Rosie for a scan.
The scanning facilities are available Mon–Thurs:
0945–1130, and Fri: 0915–1100, which allows for eight
scans to be performed daily. Any emergency referrals that can
not be accommodated on the scanning list, or are made outside
these hours, can be made through the on-call registrar or directly
to The EPU.
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