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24 Jul 2012 |
FPAHK's specialized clinic for management of early pregnancy complications
The Family Planning Association of Hong Kong (FPAHK) has set up a specialized clinic, the Early Pregnancy Assessment Clinic (EPAC), to provide clinical assessment, diagnosis, management and referral for specialist follow up care to pregnant women for detecting and managing miscarriage or complications during their early pregnancy.
The EPAC, introduced in October 2009, aims to care for women who are pregnant within 14 weeks of gestation and may encounter early pregnancy problems. The EPAC served a total of 450 pregnant women with 565 visits in total since its launch till the end of April 2012. Among them, 9% had miscarriage and 23% had threatened miscarriage. 8% had pregnancy of undetermined viability and defaulted follow-up. 11% had co-existing gynaecological problems and 3 women were suspected to have congenital uterine anomaly. There were 2 ectopic pregnancies which were referred to hospital for further management. 9 pairs of twins were diagnosed. Most clients paid only one visit to the EPAC.
Early diagnosis of miscarriage and pregnancy complications which allowed prompt and appropriate management was important for the health of the expectant mother and her foetus, said Dr Grace Wong, Senior Doctor of the FPAHK. Research statistics show that miscarriage can occur up to 1 in 5 pregnancies, most of which occur before the 12th week of gestation.
It is worth noting that while the age of these clients ranged from 22 to 49, their median age lied at 32 which leaned towards the advanced maternal age of 35 and onwards. The majority of them were having their first pregnancy. The older a pregnant woman is, the more likely she would encounter pregnancy complications in some form; therefore if resources allow, women are encouraged to take early pregnancy assessment, according to Dr Wong.
Early pregnancy problems include vaginal bleeding and cramping, minor ailments of pregnancy such as nausea and vomiting, gynaecological diseases such as uterine fibroid, uterine anomaly or ovarian cyst that complicate pregnancy, and history of recurrent miscarriage, etc. Rarer ones include ectopic pregnancy, multiple pregnancies, pregnancy with an intra-uterine device and hyperemesis gravidarum which could lead to serious complications in the mother or the foetus.
At the EPAC, ultrasonography is employed to detect heartbeat of the foetus and assess gestational age, number of foetuses and the possibility of an ectopic pregnancy. A letter is available to certify the gestational age of a woman to facilitate delivery or antenatal check-up booking at a hospital. Counselling and management for minor early pregnancy ailments and referral for severe problems for specialist care were arranged as necessary. The service fee is $420 for seeing an FPAHK doctor or $540 for seeing a specialist consultant for the first visit. Additional treatments such as folate supplementation in the first trimester to prevent neural tube defect in the foetus and psychological counselling at FPAHK are available as necessary at respective charges.
Triage by nurse is required for booking an EPAC appointment. Pregnant women concerned about early pregnancy problems or suspected of complications may consult one of the FPAHK’s six Birth Control Clinics. Please browse the FPAHK Website at www.famplan.org.hk for details or call the FPAHK Clinic Services Hotline on 2572-2222 for enquiries.
