Early Pregnancy Assessment Service (EPAS)

The Early Pregnancy Assessment Service (EPAS) provides non-acute outpatient care for women experiencing pain and/or bleeding before 14 weeks of pregnancy.

If your patient is clinically stable and does not require urgent medical review, please do not send them to the Women's Emergency Care (WEC). WEC does not routinely offer ultrasound or BHCG surveillance, and will refer the woman to EPAS if she is <14 weeks pregnant with pain and/or bleeding and clinically stable.

Services available

We provide a multidisciplinary model of care with obstetricians, gynaecologists, GPs, nurses, midwives, social workers and ultrasonographers.

  • Ultrasound (usually transvaginal)
  • Serial follow-up and surveillance (serial ultrasound, Beta hCG)
  • Diagnostic testing (e.g. histopathology, karyotype testing)
  • Anti-D if indicated
  • Referral to the Women’s services as needed (e.g. surgical, bereavement, abortion services)

Inclusion criteria

Management of women <14 weeks pregnant with any of the following:

  • Bleeding
  • Pain
  • Pregnancy of unknown location (PUL)
  • Intrauterine pregnancy not visualised on ultrasound and inappropriately rising or slow rising Beta hCG levels
  • Threatened or incomplete miscarriage
  • Retained products of conception post a miscarriage (not post-birth or abortion – see Exclusion criteria)
  • Possible uterine arteriovenous malformation
  • Suspected molar pregnancy

EPAS accepts referrals when the Women’s is the patient’s closest maternity hospital, or the patient requires tertiary level care (complex medical patients or suspected non-tubal ectopic e.g. cervical or caesarean scar).

Urgent referral

If your patient is clinically unwell and requires urgent care, call Triple Zero (000) or send them to their local emergency department.

Please advise patients in early pregnancy to present to Women’s Emergency Care (WEC) for assessment if any of the following apply:

  • Haemodynamically compromised/clinically unstable
  • Confirmed ectopic pregnancy
  • Suspected ectopic pregnancy on the weekend (EPAS service not available)
  • Severe pain
  • Continued heavy vaginal bleeding
  • Retained products post-birth

Exclusion criteria

Referral instructions

Essential information

All referrals must include essential demographic, medical and social history details, and relevant information about the presenting complaint.

In detail: Women's health referrals

Investigations

  • EDC and if known, date of last menstrual period
  • Ultrasound/s performed in the current pregnancy (preferably transvaginal)
  • Beta hCG level(s)
  • Blood group (if available)

Send referral

A referral from a GP or other specialist is required. This is not a walk in or self-referral service.

Refer to EPAS via Fast Fax: (03) 8345 3036.

Use our Women’s Health Referral Form – jump to Referral templates (Downloads).

Note to GPs: Even if your patient is seen by EPAS, a maternity referral is still required for continuing pregnancies – visit Maternity referrals.

Patients accepted for care will receive a phone call from an EPAS nurse within 72 hours (including weekends) of receipt of their referral.

In detail: How referrals are processed

Appointments

EPAS clinics are held Monday to Friday, every weekday morning and some afternoons.

Nursing staff are available for phone enquiries until 4:30pm daily. The service is closed on Saturdays, Sundays and public holidays.

Please consider this when you decide if the woman should be referred to EPAS or WEC.

Note:

  • Please do not send patients directly to EPAS without an appointment.
  • Some patients require multiple appointments until a diagnosis is made.
  • EPAS appointments may take up to 3 hours depending on clinical need.
  • The accredited sonographer may be male.


Date reviewed: 15 January 2025

Date reviewed: 15 January 2025