What is emergency gynaecology?

Women with suspected emergency gynaecological conditions will be seen acutely in the hospital setting by a gynaecologist.  You may be referred to the gynaecology team with an acute problem by the A&E department or by your GP.

Common gynaecological emergencies

  • Severe pelvic or lower abdominal pain – this might be caused by an ovarian cyst accident or abscess
  • Severe pelvic pain in early pregnancy – this might represent an ectopic pregnancy
  • Heavy bleeding in early pregnancy
  • Severe vomiting in early pregnancy (hyperemesis)
  • Bartholins abscess – this is an infected vaginal swelling at the base of the vaginal opening
  • Vulval abscess
  • Ovarian hyperstimulation syndrome (OHSS)

Post operative complication following gynaecological procedure.

ESAC

This is a specialist emergency surgical assessment clinic and is located adjacent to A&E.  It is open during working weekday hours and is closed at the weekends.  All women with suspected gynaecological problems need to be discussed with the gynaecology team before a referral to ESAC is made.

Women will be told a specific date and time to attend ESAC.  Some women will just be awaiting review by the gynaecology team but many will first have to have a pelvic scan and or blood tests first.  You will be told beforehand whether you will be having these investigations.  Often there is a bit of a wait to see the gynaecology team whilst we wait for the results of any tests.  Most women are with us for the majority of the morning.

For all women having a pelvic scan, this is normally anytime from 08:30 in the morning onwards.  Most women attending will need a transvaginal or internal scan.

Note ESAC is a mixed clinic and there will be male patients awaiting assessment by other surgical teams.

SAU

Over the weekend and bank holidays ESAC is closed so patients will be asked to attend the SAU (surgical assessment unit) instead.  This is a surgical inpatient ward in the old building with a waiting room and ward chair area for day attenders to await review.  This is a very busy mixed ward.

Whether you are attending ESAC or SAU, the gynaecology team will endeavour to see you in a timely manner once any pending investigations are back.  Please bear in mind that it is normal to wait a couple of hours for review.  The gynaecology team can often be very busy looking after all labour ward and gynaecology inpatients.

Referrals

If you are a GP or clinician calling from a minor injuries unit / A&E please refer directly via switchboard to the on call consultant in hours and the gynaecology registrar out of hours.

If you are calling to refer to EPAC please call EPAC directly.  Patients cannot self refer to this service.  Please note that patients must be booked or going to book at Musgrove park hospital – we will not see patients booked at Bristol / Bath / Exeter etc.  Women must be 14 weeks or under to be seen in EPAC.