Skip Ribbon Commands
Skip to main content
Menu

Early Pregnancy Assessment Unit

The Early Pregnancy Assessment Unit (EPU) is a specialist centre within the Department of Obstetrics & Gynaecology at Singapore General Hospital. It provides diagnosis, treatment and counselling services for women experiencing vaginal bleeding or pain in the first 14 weeks of pregnancy.

Why am I experiencing pain or bleeding?


Vaginal bleeding and pain in early pregnancy are common and do not always indicate a problem. However, these symptoms can sometimes be warning signs of

  • Miscarriage
  • Ectopic pregnancy (pregnancy outside the womb)
  • Rarely, molar pregnancy (growth of abnormal placental tissue)

What can I expect at EPU?

The EPU team consists of doctors, nurse counsellors and sonographers. The team will assess your symptoms, perform a physical examination and order any necessary tests. This may include

Internal examination: To evaluate the appearance of your cervix and extent of bleeding

Ultrasound scan: Performed though the abdomen (“trans-abdominal”) or vagina (“trans-vaginal”) to visualise your pregnancy. Transvaginal scans are generally painless but may be mildly uncomfortable for some patients.

     

Both internal examinations and transvaginal ultrasounds are safe in early pregnancy.

Blood tests: To measure the level of pregnancy hormones.

 

What will be the outcome of the assessment?

Most patients with bleeding or pain will have a normal pregnancy. This is known as a threatened miscarriage where symptoms occur but the pregnancy continues.

Sometimes, the bleeding or pain is due to a miscarriage where the pregnancy is no longer developing (please refer to the brochure “Early Pregnancy Loss” for more information). Your doctor will discuss your treatment options in this situation. 

Occasionally, an ectopic pregnancy is found where the pregnancy is growing outside the womb. This can bleed internally and be life-threatening if allowed to continue growing. You will need treatment and your doctor will discuss the options with you. 

Rarely, the symptoms result from a molar pregnancy. This is an abnormal pregnancy where both the placenta and baby do not develop properly. This usually needs to be removed surgically.

In some instances, the diagnosis may be uncertain. This can happen because of inaccurate menstrual dates or if it is too early to see the pregnancy on ultrasound. You may need a blood test to measure your level of pregnancy hormones and a follow-up appointment for a repeat assessment.

Can I make an appointment with EPU?


The EPU caters to pregnant patients under 14 weeks with

  • Vaginal bleeding and / or pain
  • History of recurrent miscarriages
  • History of ectopic pregnancies
  • History of ≥2 previous Caesarean Sections
  • An intrauterine contraceptive device in-situ
  • We accept

  • Self-referrals from patients with the symptoms or conditions above
  • Referrals from General Practitioners
  • A&E patients during office hours
    •  

    How do I make an appointment?


    The EPU is located at the Prenatal Diagnostic Centre, Block 5 Level 2, Singapore General Hospital. There is a comfortable waiting area with access to a private room for consultations and ultrasound scans.

    We are open for consultations from 9am to 5pm, Monday to Friday. Please contact us at (65) 6321 4516 and inform our staff that you would like an “EPU appointment”.