Early Pregnancy Assessment Service (EPAS)

WNHS at KEMH has a specialised service to review patients with problems in the first trimester of pregnancy, including pain and bleeding which may represent suspected miscarriage or ectopic pregnancy.

If there is an EPAS service at the local maternity hospital, refer to them in the first instance. EPAS clinics are also available at Joondalup Hospital, Fiona Stanley Hospital, Armadale Hospital and Midland Hospital.

The dedicated Early Pregnancy Assessment Service (EPAS) at WNHS at KEMH provides a senior clinician-led service with ultrasound support.

 

Clinical inclusion

Gestation cut-off for EPAS is 13 weeks’ gestation. Women in the first trimester who have had a positive pregnancy test and one or more of the following:

  • Abdominal / pelvic pain.
  • Vaginal bleeding.
  • Previous ectopic pregnancy.
  • Previous tubal surgery.
  • Two or more previous miscarriages.
  • Intra-uterine Contraceptive Device in-situ.

 

Frequency of clinic

Monday, Wednesday, Thursday and Friday from 8:30am to 12:30pm.

 

Referral to include

  • Quantitative bHCG.
  • Copy of ultrasound reports from current pregnancy if available.
  • Detailed obstetric and gynaecological history as well as medical history.

 

Clinical exclusion

  • Gestation greater than 13 weeks – refer to the Emergency Centre at local maternity service or WNHS at KEMH.
  • Fetal anomaly detected on ultrasound – contact Maternal Fetal Medicine Senior Registrar to discuss on (08) 6458 2222.
  • If the patient is haemodynamically unstable, has severe pain or heavy vaginal bleeding call ambulance as needed and the KEMH Emergency Department on (08) 6458 1431 if presenting to KEMH.
  • EPAS does not refer onwards for antenatal care, first trimester screening / NIPT or referral to specialist clinics such as the Pre-term Birth Prevention Clinic or Maternal-Fetal Medicine.

If a woman requires these services, a further referral needs to be sent by GP to the local maternity service or, if a WNHS at KEMH patient, direct referral to WNHS at KEMH Referral Co-ordinator via:

  • Use the KEMH antenatal referral form or own software template including detailed information.
  • Attach required information for antenatal referral

Send referral to KEMH Referrals Co-ordinator:

Email: KEMH.Referrals@health.wa.gov.au
In Subject line write “Antenatal Referral, Patient surname”
Fax: (08) 6458 1031
Healthlink: not yet available

 

Urgent referrals

Ring and discuss urgent referrals to EPAS on (08) 6458 1686 during EPAS clinic between 8.30am and 12.30pm on Monday, Wednesday, Thursday and Friday.

Outside these times ring KEMH Emergency Department on (08) 6458 1431.

 

Referral options

Patients need to be referred to the service via telephone first and are given an appointment to attend the clinic.

Do not send referral letter to WA Health Central Referral Service as it can take several days for the referral to be passed on to EPAS.

Urgent and non-urgent queries can be directed to EPAS:

Tel: (08) 6458 1686 during the clinic times.

If unavailable, ring to refer the patient and book an appointment via the Emergency Department on (08) 6458 1431 which is available 24/7.

You will be advised of where to send the referral letter during this call.

 

Contact information

For urgent queries regarding pregnancy less than 20 weeks gestation, ring (08) 6458 2222 and ask for the Gynaecology Registrar on call. For urgent queries regarding pregnancy over 20 weeks gestation, ring (08) 6458 2222 and ask for the Senior Obstetric Registrar on call.

 

Useful links

Early Pregnancy Assessment Service (EPAS) (external site)

Last Updated: 17/12/2021