The impact of a pregnancy confirmation clinic on the commencement of antenatal care

Objective. To introduce a pregnancy confirmation clinic as part of antenata l care and to determine whether this would alter the gestational age at whi ch patients commence antenatal care. Setting. Three municipal antenatal clinics in Atteridgeville and Central Pr etoria. Method. A pregnancy confirmation clinic was set up at three sites. At the c linic any woman wishing to confirm whether she was pregnant was offered a u rine beta-HCC test. If this test was positive, on-site testing for syphilis , anaemia and rhesus status, dipstick testing of the urine, clinical examin ation and ultrasound examination were performed. Women with abnormal test r esults were commenced on appropriate treatment immediately and women requir ing further medical care or investigation were referred appropriately. Results. The study recruited 382 women, 145 of whom were defaulters from co ntraception. Half of the women (191) had a positive pregnancy test. The mea n presenting gestational age was 12 weeks 4 days (standard deviation 5 week s, range 5 weeks - 25 weeks 2 days). Treatable conditions with the potentia l to influence pregnancy outcome were identified in 37 of the pregnant wome n (19.4%) Forty-three of the pregnant women intended to terminate the pregn ancy. Conclusion. It is possible to shift the commencement of antenatal care to a n earlier gestational age.