Impact of consultant-led care in early pregnancy unit.

Early pregnancy complication remains a significant cause of maternal morbidity and mortality. Despite the paucity of evidence to support consultant-led early pregnancy unit over nurse- or sonographer-led services, hospitals have devoted scarce resources to appoint consultants to lead their early pregnancy units. We compared the management and outcomes of confirmed and suspected ectopic pregnancy 1 year before and one year after the transition from a nurse-led to a consultant-led early pregnancy unit in a London hospital. Our study showed improvements in the rates of negative laparoscopy, ruptured ectopic pregnancy during follow-up, need for laparotomy, ITU admission and length of stay and statistically significant reduction in operative intervention, without concomitant rise in morbidity or mortality in women with confirmed or suspected ectopic pregnancies.