Our Services

The Early Pregnancy Assessment Unit

The Early Pregnancy Assessment Unit (EPAU) is a purpose built unit situated within the antenatal clinic at Macclesfield District General Hospital. The unit is open five mornings per week Monday – Friday between 8.15 am and 11.00 am. Referrals are received via GPs and midwives following set criteria.

Referral criteria

  • Positive pregnancy test and vaginal bleeding or clinically suspicious of an ectopic pregnancy – up to 14 completed weeks of gestation.
  • Positive pregnancy test and a history of:
  • Ectopic pregnancy
  • Sterilisation
  • Tubal surgery
  • Contraceptive coli insitu 
  • Antiphospholipid syndrome
  • Previous recent attendance at EPAU where condition has changed.
  • Follow-up after medical management of miscarriage, ectopic or termination of pregnancy.

Please note:

Women over 14 weeks gestation who develop a clinical symptom should be referred for an emergency antenatal clinic appointment or for emergency care.

Our services

The EPAU has a lead obstetrician and is run on a daily basis by midwives with the support of maternity care assistants. An ultrasonographer is available during each session. Further management of ectopic is also available as clinically appropriate.  

We offer conservative, medical and surgical management of missed miscarriages providing individualised, informed choice in line with the Royal College of Obstetricians and gynaecologists guidelines. Medical management of ectopic pregnancies is also available to some women.
The staff have links with the Association of Early Pregnancy Units in the North West and have recently become involved with the new North West Forum for Emergency Gynaecology.
The staff also offer a listening and support service for women who have been seen in the EPAU.

Preconception and recurrent miscarriage service

A new preconception and recurrent miscarriage service is now available at Macclesfield Hospital and is led by Mr Devaraj, Consultant Obstetrician and Gynaecologist. Referral to this service is via your GP.

Aims of the service

The preconception service aims to :

  • Optimise maternal health before pregnancy to give the best chance  of a successful birth.
  • Target women with preexisting medical conditions.
  • Provides information to women about how their conditions will affect the pregnancy and how their pregnancy in turn will affect their own health.

This service is in line with national policies such as Maternity Matters, National Service Framework for children,young people and maternity services and Centre for Maternal and Child Enquiries (CEMACH) -Saving mothers lives.

What we offer

The preconception service provides counselling regarding :

  • General preconception eg care planning for pregnancy.
  • Specific obstetric preconception information about, existing medical conditions,recurrent miscarriages or previous obstetric complications.

Examples of conditions 

We see patients with the following conditions:

  • Endocrinology: for example thyroid disorders, diabetes.
  • Neurology: Epilepsy, Multiple Sclerosis, Narcolepsy.
  • Genetics: Cystic Fibrosis,Trisomy and other syndromes.
  • Haematology: Thrombocytopenia, Haemoglobinopathy, Antiphospholipid syndrome.
  • Immunology: Rheumatoid arthritis
  • Respiratory: Asthma
  • Cardiology: Coronary heart disease

Recurrent miscarriages

The recurrent miscarriage element of this service is aimed at patients who have had three or more miscarriages. Patients are investigated to identify possible causes for example genetic factors, medical conditions, uterine abnormalities, infections and maternal age. This service aims to help patients in planning for a future pregnancy by optimising their care from the very beginning ie from the preconception period itself. This service can help many couples who have had recurrent miscarriages still have  a good chance of a successful pregnancy in the future.

If you would like more information about this service please contact Mr Devaraj on 01625 661167.                                


Name  Title  Number 
Dr S Dean      Consultant Obstetrician and Gynaecologist      01625 661162
Mr R Devaraj Consultant Obstetrician and Gynaecologist            01625 661167
Mr V Hall Consultant Obstetrician and Gynaecologist     01625 661161
Mr J Kabyemela Resident Consultant Obstetrician & Gynaecologist 01625 661167
Dr S Nausheen Consultant Obstetrician and Gynaecologist 01625 661161
Dr I Rabbani Resident Consultant Obstetrician and Gynaecologist 01625 661167
Lorraine Perry Antenatal and EPAU Clinic Manager     01625661163 











More information

If you would like any further information then please do not hesitate to contact us:
EPAU Manager – 01625 661 160


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