Early Pregnancy Loss

Miscarriage Clinics

The recognition that early pregnancy loss has a significant psychological impact on a woman and her partner has prompted a number of improvements in the management of spontaneous miscarriage. Women are now admitted to the gynaecological wards rather than the maternity wards in recognition of the sensitive nature of this event. Information and counselling is provided. In this regard, the hospital has produced it’s own information sheet on spontaneous miscarriage because we recognise that couples are often unable to absorb verbal communication immediately after the miscarriage.

All women are offered a follow up appointment and those not attending a consultant are given an appointment for the Miscarriage Clinic which is held in the Margaret Boyle Clinic.

Clinical Manager Elizabeth O’Beirne tries to see as many women as possible before hospital discharge and also attends the Miscarriage Clinic to provide continuity of care. The Chaplain and Social Work Department review those women needing additional support Private patients who miscarry are not given an appointment for the miscarriage clinic but return to se their own consultant.

Ectopic Pregnancy

Ectopic pregnancy occurs when implantation of the fertilised egg occurs outside the womb. This nearly always occurs in the fallopian tube although it may rarely occur on the ovary or deep in the pelvis.

It is impossible to say precisely how often this occurs but it seems to be about 1 in every 300 deliveries.

The most common associated factor for ectopic pregnancy is a past history of pelvic inflammatory disease. Other associated factors include previous tubal surgery the use of an IUCD or Coil or a previous ectopic pregnancy. Hormonal causes such as the use of the progesterone only pill may also contribute.

A Tubal or Ectopic pregnancy can present in many ways and misdiagnosis may occur. The most common presentation is of a missed period with lower abdominal pain often localised to one side. This may be accompanied by unexpected vaginal bleeding. The result of internal bleeding may result in pelvic irritation and muscle guarding and sometimes frequency of micturition. This often results in a women being misdiagnosed as having appendicitis or a kidney infection.

In such circumstances a woman should present herself to the hospital A&E department. A confirmatory pregnancy test and abdominal examination coupled with an ultrasound scan of the pelvis will confirm most cases. If there is any doubt as to the diagnosis admission to hospital will occur and a diagnostic laparoscopy will be performed. This allows for direct visualisation of the fallopian tubes and other pelvic organs including the appendix. At the same time Laparoscopic or Keyhole surgery may be performed if necessary.

Useful Links

Miscarriage Association of Ireland

Chaplaincy Service (Fr.B.Molloy)

Church of Ireland
Reverend Cannon Crawford
Phone No 4542274

Reverend David Pierpoint
8304601

Presbyterian Church
Reverend David Bruce