General gynaecological emergencies

On this page​​

1. Adult Gynaecological Oncology
1. Abnormal cervical screening
2. Abnormal uterine bleeding
3. Dysmenorrhoea
4. Pelvic mass
5. Persistent pelvic pain
6. Post-coital bleeding
7. Post-menopausal bleeding
8. Prolapse
9. Urinary incontinence
10. Vulval disorders
11. Non-condition specific

Adult patients (aged 16 years or over) ​

Abnormal cervical screening

• ​Nil emergency criteria

Abnormal uterine bleeding

• Acute or severe pelvic pain
• Haemodynamic instability
• Inevitable and/or incomplete termination
• Persistent heavy menstrual bleeding with haemoglobin < 70 mmol/L

Dysmenorrhoea

• ​Acute or severe pelvic pain

Pelvic mass

• Acute or severe pelvic pain
• Suspected ovarian torsion
• Suspected pelvic abscess

Persistent pelvic pain

• Acute abdominal pain secondary to trauma
• Acute pelvic pain

Post-coital bleeding

• Acute trauma including vulva or vaginal lacerations, haematoma and/or penetrating injuries
• Inevitable and/or incomplete miscarriage or termination
• Uncontrolled vaginal bleeding and haemodynamic instability

Post-menopausal bleeding

• ​​Uncontrolled vaginal bleeding or haemodynamic instability.

Prolapse

• Irreducible procidentia
• Prolapse with acute urinary retention
• Severe pain
• Systemic infection
• Uncontrollable bleeding

Urinary incontinence

• Acute urinary retention
• Fournier's gangrene
• Frank haematuria
• Urinary incontinence with any evidence of cauda equina symptoms
• Urosepsis

Vulval disorders

• Acute painful enlargement of Bartholin's gland > 3 cm
• Acute painful presentation with a vulval cyst or abscess
• Acute trauma, including any of the following features:
• Haematoma
• Penetrating injuries
• Vulval or vaginal lacerations

Non-condition specific

• Bartholin's abscess or acute painful enlargement of a Bartholin's gland or cyst
• Concerns of sexual assault or childhood non-accidental vulval or vaginal injury
• Ectopic pregnancy (suspected or confirmed)
• Evidence of haemodynamic compromise (e.g. hypotension, postural hypotension, tachycardia) with or without vaginal bleeding
• Hyperemesis gravidarum (i.e. PUQE score > 13)
• Inevitable and/or incomplete miscarriage
• Known cyst with sudden onset of severe pain (possible ovarian torsion)
• Ovarian hyperstimulation syndrome
• Pelvic or tubo-ovarian abscess
• Post-operative complications within 6 weeks, including wound infection, wound breakdown, vaginal bleeding or discharge, retained products of conception, abdominal pain
• Rupture haemorrhagic ovarian cyst
• Significant vaginal bleeding