Call to shake up early pregnancy care

The British National Health Service needs dedicated services for pregnant women who suffer serious complications in their first three months, according to guidelines published today.

The services would aim to identify and help women who may have an ectopic pregnancy - in which the baby is growing outside the womb.

The guidance from the National Institute for Health and Clinical Excellence also sets out new advice for GPs to help them recognise these problems.

And it calls for regional pregnancy assessment services to be available seven days a week to ensure women can get scans and expert medical care.

More than 10,000 women a year are known to suffer from these complications - and in six cases it led to death in the three years from 2006 to 2008.

Professor Mark Baker, of NICE, said: "It can be very distressing and, in some cases, frightening to experience a miscarriage or be told your pregnancy is ectopic. It's vital that women and their families receive good, consistent, timely and effective care and support that addresses their needs and enables them to make informed decisions.
"We know that not every woman is receiving this level of treatment at the moment but this guideline will address that inconsistency and ensure all women receive excellent care, no matter where they live."

The guidance was welcomed by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives.

Obstetricians' president Dr Tony Falconer said: “While diagnosis of and mortality rates for ectopic pregnancies are low there is still much that can be done to improve early detection methods in women of child-bearing age, reducing the risk of complications and raising awareness of the symptoms is essential.

"The role of timely and accurate information is a key message in these guidelines and in order to provide patient-centred care the needs of pregnant women should be foremost in decisions on the design and provision of healthcare facilities."

And for the midwives, Jane Munro said: "The guidelines will also help to raise awareness of the signs and symptoms of a potential ectopic pregnancy amongst all healthcare professionals involved in the care of women of reproductive age. We look forward to their widespread implementation."

GP Dr Nicola Davies, who helped develop the guidelines, said: "I have seen two cases where an ectopic pregnancy was diagnosed but the women in question had no idea they were pregnant.

"By producing a list of potential signs and symptoms and also recommending that healthcare professionals should have access to pregnancy tests for women of reproductive age, the guideline promotes earlier diagnosis of ectopic pregnancy. This will mean that women receive appropriate care sooner and avoid serious complications."