Primary care follow-up and measured mental health outcomes among women referred for ultrasound assessment of pain and/or bleeding in early pregnancy: a quantitative questionnaire study

Journal article

OBJECTIVES: To examine the extent of primary care follow-up and mental health outcomes among women referred for ultrasound assessment of pain and/or bleeding in early pregnancy, including those whose pregnancy is found to be viable on ultrasound assessment. DESIGN: Questionnaire study with prospective follow-up. SETTING: Urgent gynaecology clinic in secondary care, England. PARTICIPANTS: 57 women participated in the study. Entry criteria: referral to the urgent gynaecology clinic with pain and/or bleeding in early pregnancy; gestation less than 16 weeks (the clinic's own 'cut-off'); no previous attendance at the clinic during the current pregnancy. EXCLUSION CRITERIA: inability to understand English or to provide informed consent. PRIMARY AND SECONDARY OUTCOME MEASURES: Incidence of primary care follow-up among women referred to the urgent gynaecology clinic; incidence of women with measured mental health scores suggesting significant symptoms of distress. RESULTS: Fewer than 1 in 10 women referred for ultrasound assessment of pain and/or bleeding in early pregnancy had follow-up arrangements made with their general practitioner (GP). Most women who had GP follow-up found it helpful and a significant minority of women who did not have GP follow-up felt that it would have been helpful. Following ultrasound assessment, more than one-third of women had significant symptoms of distress. Symptoms of distress, particularly anxiety, were present among those women found to have viable pregnancies, as well as among those with non-viable pregnancies. CONCLUSIONS: GPs are advised to consider offering follow-up to all women referred for ultrasound assessment of pain and/or bleeding in early pregnancy. Researchers in this area are advised to consider the experiences of women with pain and/or bleeding in early pregnancy whose pregnancies are ultimately found to be viable on ultrasound scan.

Authors: Moscrop, A; Harrison, S; Heppell, V; Heneghan, C; Ward, A

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BMJ Publishing Group
• Journal: BMJ Open
• Publication date: 2013-04-14
• Acceptance date: 2013-03-13
• DOI: 10.1136/bmjopen-2013-002595
• EISSN: 2044-6055
• Language: English
• Keywords: referral and consultation; pregnancy; Health Services Administration and Management; SBTMR; Gynaecology; miscarriage; Primary Care