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Gynaecology

The department of Gynaecology provides a complete range of care for medical conditions specific to women. General gynaecological outpatient clinics are held at both hospitals. In addition specialist outpatient clinics are held for:

  • Pelvic pain investigations and treatment programmes
  • Gynaecological and dermatological investigations and treatments
  • Menopause clinics
  • Hormone replacement therapy and implant clinics
  • Abnormal bleeding clinics
  • Colposcopy clinics
  • Hysteroscopy clinics
  • Infertility
  • Your GP has requested that you are seen within 2 weeks

We currently have 16 Gynaecology Consultants working between both hospitals. Each gynaecological Consultant has a special interest and your GP will usually refer you to a Specialist according to your problem, i.e. endometriosis, chronic pain, uro-gynacological disorders, dysfunctional uterine bleeding etc.

At your appointment you may be seen by a Consultant or a Doctor in training, who will refer you to a Consultant if advice is needed. We also have a Clinical Nurse Specialist who has undertaken further training and has her own clinic for urodynamics and colposcopy services.

The Gynaecology services are staffed by dedicated nurses who have a specialist interest in women’s health.

We have a dedicated Early Pregnancy and Emergency Gynaecology Service which operates Monday to Friday 8am -8pm. Referral is through your GP or other professional who deems this the correct pathway for your treatment. If you are experiencing problems when there is no access to your GP, you will need to attend the Accident & Emergency department.

Patient information leaflets

Endometriosis

MTW has a specialist Endometriosis nurse, who is dedicated to helping and providing support to women with this condition.

She can be contacted via email: mtw-tr.endo-helpandsupport@nhs.net or mobile: 07887 951397

 

Early Pregnancy Assessment Clinic

What is the Early Pregnancy Assessment Clinic?

An Early Pregnancy Assessment Clinic (EPAC) is a staffed by a dedicated team of nurses, doctors and ultra-sonographers.  The team see women and their partners when there is a problem during the first 16 weeks of pregnancy. They specialise in seeing women experiencing pain and bleeding in this early stage of pregnancy.

When should you attend the Early Pregnancy Assessment Clinic?

If you are in the first 16 weeks of your pregnancy and you are experiencing pain and or bleeding, this can be light spotting to heavier bleeding much more than a normal period bleed. You may see clots/brown discharge or other tissue.
If you have a referral from your GP or midwife.
If you are experiencing any abdomen pain

 

What can you do for me at the Early Pregnancy Clinic?

On arrival to the clinic you will be asked to complete a triage and registration form. Please ask if you need help to fill in any aspect of the forms.  A urine sample will be needed to check for urinary infections and we also will perform a pregnancy test before the ultra-sonographer or consultant Gynaecologist will scan you. You will not need a full bladder in less than 12 weeks of pregnancy unless requested in order to have your scan

Blood Tests

We may need to take blood from you to check the hormone levels in your blood and in some cases your blood group. The nurse or doctor will speak to you about your scan finding and any other blood tests you have had.

When we take blood for hormones called a Beta HCG, you will need a repeat test in 48 hours. The Doctors will call you on the day of the test after 8pm. Sometimes an emergency prevents the doctors from making contact with you and will seek to call the following day.

Do I need an appointment?

The Early Pregnancy Clinic at Tunbridge Wells Hospital runs to timed appointments. These appointments can be made by your GP, Midwife or the Emergency Department. Sometimes emergency patients need to be seen and you may have to wait for your scan or doctors review. We will advise of any waiting times on the day.

 

What type of Scan will I have?

In the early stages of pregnancy the uterus (womb) is still within your pelvis therefore an internal Transvaginal Scan (TVS) is necessary, this is where an ultrasound probe is inserted vaginally.

If you do not wish to have an internal scan, we can offer an external scan called a transabdominal scan, however please be aware that in the early stages of pregnancy these scans may not provide as much information and you will be able to discuss this option with the ultra-sonographer.

The ultra-sonographer will explain the scan to you and if you need to see a nurse or a doctor you will be asked to take a seat in the waiting area.

 

It may not be possible to tell whether your pregnancy is continuing with the first scan, this is due to the early gestation. We do not scan women under 5 weeks of pregnancy; this is because the heart of the baby only starts to beat at six or seven weeks after your last period.  The only way to we can tell the difference between a viable pregnancy and one that is failing it to repeat the scan in one or two weeks dependent on the finding of the initial scan. The common findings can be separated into these categories.

 

Pregnancy of Unknown Location (PUL).

Where we have been unable to locate the pregnancy with a scan and the hormone levels from blood tests are low.  The main reasons behind a PUL:

The pregnancy is under 5 weeks; this can be due to irregular periods and long cycles and patients unsure of their last menstrual period.
The pregnancy may have been lost prior to the scan being performed. You have experienced some vaginal bleeding which may not have been heavy as the pregnancy was very early. The pregnancy hormones may be still present in your urine and can take up to 10 days to disappear after a pregnancy loss
Ectopic Pregnancy. This can potentially be dangerous; you will be closely monitored to allow for early diagnosis to prevent internal bleeding.

 

Pregnancy of Unknown Viability (PUV).   

When a Sac is identified in the womb correctly, however we cannot visualise a fetus with a heartbeat. If you are in very early pregnancy this can be a normal finding as the fetus has not yet grown. Unfortunately if you are further along in your pregnancy this may mean that the pregnancy has failed.

You will be rebooked for a follow up scan in a minimum or 7 days maximum 14 days, to confirm viability.  If the pregnancy is failing it is possible that you may spontaneously bleed and miscarry before the follow up appointment.

 

 

Ectopic Pregnancies

If you discover you have an ectopic pregnancy, (this is where the pregnancy grows outside the uterus, for example the fallopian tube), you will need to be seen by a doctor and blood test taken.

In some cases it is necessary to have a physical examination to rule out and ectopic pregnancy or to look at your cervix. In this case there will be a chaperone present

 

Molar Pregnancies. 

A Rare condition where there is excessive placental development and little or no fetal development.

Partial Molar – This is where two sperm fertilize an egg instead of one and too much genetic material is produced for the fetus to develop
Complete Molar This is where one to possibly two sperm fertilize an egg with no genetic material inside, there is a lack of chromosomes for the fetus to develop

Sample of tissue form the molar pregnancy will be taken and sent to Charring Cross for analysis and you will be under the care of a Gynaecology consultant and monitored closely

 

The Team at the Early Pregnancy clinic  understand that this can be a stressful and anxious time for you and your family and will do their best to make you comfortable and at ease. If you have any concerns the staff will endeavour to give you verbal and written information about your treatment.  You will also be given the Clinics telephone number should you have any concerns or questions once you arrive home.