A Canadian urban early pregnancy assessment clinic: a review of the first year of operation

Abstract

Objective: To review the services provided by an early pregnancy assessment clinic (EPAC) in Vancouver, British Columbia, and to assess the characteristics of the women accessing their services and their satisfaction with the care provided.

Methods: The EPAC at BC Women's Hospital and Health Centre was opened in September 2007 to offer assessment of early pregnancy complications and management of early pregnancy loss. We conducted a review of the records of all patients who accessed the clinic in its first year of operation to review the origin of referrals, patient assessments, diagnoses, treatment, complications, and follow-up. Additionally, we distributed satisfaction surveys to patients.

Results: A total of 411 patients were referred to the EPAC in its first year of operation. Most referrals were from family physicians (38%), and the primary reason for referral was most commonly cramping and/or spotting (57%). The mean wait time for patients to be seen was 2.02 working days, and the majority of women (91%) were given a diagnosis at their first clinic visit. After assessment, 48% of women had manual vacuum aspiration or dilatation and curettage arranged, 21% had expectant management, and 17% required no treatment, because of complete miscarriage. While 94% of patients with non-viable pregnancies were treated at EPAC, 6% were referred to other health care agencies. In the satisfaction surveys completed, comments about the EPAC were largely positive and primarily focused on the emotional support and level of care received.

Conclusion: In its first year of operation, the EPAC was well used and provided efficient and compassionate care. Patients reported high satisfaction with the quality of care received from staff, and showed particular appreciation for the emotional care received.