The guidelines include the following recommendations:

• Hospitals should provide dedicated outpatient early pregnancy assessment units (EPAU)
• EPAUs should have access to transvaginal ultrasound with staff appropriately trained in its use.
• For pregnancies of ‘uncertain viability’ in order to confirm or refute viability, a repeat scan at a minimal interval of 1 week is necessary.
• In terms of therapeutic intervention, patient choice should be encouraged, as it is associated with positive quality-of-life outcomes.

Maternity units nationwide adopt the recommendations outlined in the guidelines depending on the local availability of properly trained obstetrical, midwifery, ultrasonographic and ancillary staff, the availability of ultrasound equipment that is 'fit for purpose' and hospital facilities suitable for and designated to Early Pregnancy Assessment Unit functions.

Maternity units may alternatively assess patients with potential or actual miscarriage as emergencies via clinics, gynaecology wards, day-care, accident and emergency units or other mechanisms or facilities.

The Institute of Obstetricians and Gynaecologists, RCPI is currently formulating specific guidelines for a range of issues including miscarriage within an Irish context.

Institute of Obstetricians and Gynaecologists
Royal College of Physicians of Ireland
Main Ph: 01 8639700
iog@rcpi.ie