There are many issues that can occur in early pregnancy, the most common being bleeding in early pregnancy. Whilst this may be a very worrying time, the majority of women who have this will have a perfectly normal scan. In fact, up to 1:4 women who have perfectly healthy babies born at term will have had bleeding in early pregnancy:
Threatened miscarriage-where there is bleeding but a scan reveals that the baby is well
Missed miscarriage-where some bleeding may have occurred or pregnancy symptoms (sore breasts/nausea) may have lessened and the baby has been seen to have died on scan
Incomplete miscarriage-where sadly, miscarriage has occurred but there are fragments of placental tissue remaining. We might advise repeat scan and blood tests to confirm this if we haven’t seen your baby on scan prior to this to exclude ectopic pregnancy.
Pregnancy of unknown location- where the pregnancy test is positive but it is not possible to see the pregnancy on scan-in this case blood tests would be ordered and a scan provided some time after the first as it might be that it is too early to see
Ectopic Pregnancy -where the pregnancy is seen outside of the cavity of the womb-most commonly in the fallopian tube
We can offer diagnosis of cause of pain and bleeding up to 12 weeks of pregnancy and offer scans for reassurance. Early pregnancy complications are one of the most distressing events in their reproductive life that women encounter. We aim to provide comprehensive, holistic investigation and management to reassure or guide you carefully through the options if you are unlucky to experience the loss of your baby.
We can also offer investigation and evidence based treatment of recurrent miscarriage. We will use the most up to date, evidence based (association of Early Pregnancy, RCOG and NICE guidance) approach. There is evidence that weekly scanning in early pregnancy provides support and reassurance that increases the chance of a live birth. Whilst, this is difficult to source in the NHS, we are happy to provide this up to 12 weeks gestation.
If all appears fine you may wish to book a further reassurance scan
If you have a missed miscarriage/incomplete miscarriage you may wish to consider one of four options:
Ectopic pregnancy-following scan diagnosis, we suggest blood tests-if levels are low and falling we may monitor you and tubal miscarriage may occur on its own. If the ectopic is large and/or blood pregnancy hormone levels are rising, one of our team will operate to remove the ectopic by opening the tube or removing it. If the tube is opened you will need blood tests to ensure that all tissue is removed.
Consultant Gynaecologist in Early Pregnancy
Christine Ekechi is a Consultant in Early Pregnancy and Acute Gynaecology. Her NHS practice is concentrated at Queen Charlotte’s & Chelsea Hospital, Imperial College Healthcare Trust, within the renowned Early Pregnancy & Acute Gynaecology Unit. Christine Ekechi also practices privately at Queen Charlotte’s Hospital and The Lindo Wing at St Mary’s Hospital with admitting rights at The Portland Hospital and The London Clinic.
Christine Ekechi’s passion lies in the delivery of complete, sensitive and holistic care in early pregnancy; and the accessibility of excellence in early pregnancy ultrasound to all women, everywhere. For Christine Ekechi, each and every pregnancy deserves compassion and empathy - whatever the outcome.
Christine Ekechi graduated from the oldest established medical school in London, St Bartholomew’s and The Royal London Medical School in 2004 and completed her specialist training in obstetrics & gynaecology with one of the most prestigious training schemes at Imperial College.
Christine Ekechi is the Lead for ultrasound training in Early Pregnancy at Queen Charlotte’s Hospital and is the ATSM preceptor for Acute Gynaecology & Early Pregnancy for the Obstetrics & Gynaecology North West London training programme. Christine regularly teaches and presents in the field of early pregnancy, has published a number of peer-reviewed papers and has authored a chapter on Miscarriage for an internationally recognised textbook for medical students.
Christine Ekechi’s other interests include international health. She has completed a public health Masters at the prestigious London School of Hygiene & Tropical Medicine following work with the United Nations at their headquarters in New York.
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The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.