pregnantThe NHS should consider setting up dedicated services for pregnant women who may have an ectopic pregnancy or who experience pain or bleeding in their first trimester according to new NICE guidelines.

The National Institute for Health and Clinical Excellence (NICE) say that while the majority of pregnancies progress successfully, around one in five will result in a miscarriage. Ectopic pregnancies (when the fertilised egg lodges and begins to develop in the fallopian tube rather than the uterus) occur in 11 out of every 1,000 pregnancies.

In England during 2010-11, a total of 54,162 women had either a miscarriage or an ectopic pregnancy which resulted in an NHS hospital stay.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said in a press release: "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."

NICE's guidelines recommend regional services be organised so that an early pregnancy assessment service is available seven days a week. Women with early pregnancy complications could be seen there, scans carried out and decisions made about how their pregnancy should be managed.

The Royal College of Midwives has welcomed the NICE guidelines and says it looks forward to their widespread implementation. Jane Munro, quality & audit professional advisor at the RCM said the guidelines would help ensure standardised and consistent care for women: "Women experiencing pain and bleeding in early pregnancy need to be able to access help and support seven days a week."

"The focus on emotional support and information giving is important, so that women can be clear about their choices and make informed decisions. 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."

Between 2006 and 2008, there were 35,495 confirmed ectopic pregnancies and six women died during their first trimester as a direct result of their pregnancy. About two-thirds of deaths caused by ectopic pregnancy are associated with substandard care, due to missed or late diagnosis.

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Posted 13/12/2012 by