Early pregnancy assessment  service in Canberra

 JUNIC Specialist Imaging and Women’s Centre provides a community based early pregnancy assessment service (EPAS). This service has been introduced to assist women in Canberra manage all complications that could be associated with early (first trimester) pregnancy.

Dr Uche A Menakaya oversees the JUNIC EPAS service. Dr Menakaya is an Australian trained obstetrician, gynaecologist and Sonologist. He had additional fellowship training in the management of early pregnancy complications and has completed his diploma in diagnostic ultrasound.

The primary objectives of the EPAS service at JUNIC Specialist Centre include

1)      To identify the location of pregnancy as soon as possible and

2)      To confirm the viability of pregnancy as soon as possible.

This is because early identification of pregnancy location is important to rule out the risk of an ectopic pregnancy (a pregnancy located outside of the womb)  In the general population, there is a 1% – 2% risk of having an ectopic pregnancy. However this risk should be assessed as early as possible to prevent a life-threatening problem.

Secondly, up to one in five pregnancies are miscarried soon after a positive pregnancy test.  Although losing a pregnancy is tragic no matter how early it happens, the introduction of EPAS services worldwide has resulted in better patient care and satisfaction with faster times to diagnosis, continuity of care and reductions in duration and number of hospital admissions

ARE THERE OTHER ADVANTAGES OF TIMELY DIAGNOSIS OF EARLY PREGNANCY COMPLICATIONS?

Timely diagnosis of early pregnancy complications is also important because it gives women ample time and opportunity to consider the non-surgical options available for managing early pregnancy complications.

These non-surgical options include use of oral or vaginal tablets, use of special injections (methotrexate), regular monitoring with blood tests and / or regular follow up with transvaginal ultrasound.

Where appropriate Dr Menakaya will discuss these options with you to enable you make an informed decision about the option that best suits your need.

TIMING OF THE FIRST SCAN IN EARLY PREGNANCY

You can request a pelvic ultrasound as soon as your pregnancy test is positive. Evidence now shows that over 90% of all pregnancies can be located accurately at a first visit in women attending an EPAS managed by experienced specialist.

REFERENCES

1        Menakaya et al. Acute gynaecological services in Australia – time for change. Aust N Z J Obstet Gynaecol. 2014 Jun; 54(3): 195-7
2        Infante F, Menakaya U et al. Rationalising the change in defining non-viability in the first trimester. AJUM August 2013 16 (3)
3        Bradley E, Hamilton-Fairley D. Managing miscarriage in early pregnancy assessment units. Hosp Med 1998; 59: 451– 456.
4        Kirk E, Papageorghiou AT, Condous G, Tan L, Bora S, Bourne T. The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy. Hum Reprod. 2007 Nov; 22(11): 2824-8