Gynaecology

This page was updated September 2026

Consultants:

Mr D Semple; Ms S Ramakoti; Mr M Ibraheim; Ms C Channappa; Ms J Van Rij; Ms L Canavan; Ms T Finney; Mr M Cheema; Mr T Chadwick; Mr T McCormack; Ms M Thomas; Ms K Smith; Ms S Parlapalli; Ms J Parton; Ms S Brigham; Ms J Davies

Obstetrics

The overall philosophy of this service is to provide each woman with the appropriate care, at the appropriate time, for the well being of both the mother and baby. In order to fulfil this philosophy, integrated care with patient/client choice, pre-natal screening and community-based care is offered. In addition to the routine antenatal clinics held in the Obstetric Unit, one specialist medical disorder clinic, a high risk pregnancy clinic for pre-conceptual and anomaly scans and invasive procedures are held weekly. There is a weekly Consultant antenatal clinic held at Halton Hospital. All obstetric ultrasound is carried out by qualified ultrasonographers in the Maternity Ultrasound Department.

A Day Assessment Unit staffed by midwives has been instrumental in reducing the number of antenatal admissions and this has led to a reduction in the number of antenatal/postnatal beds now required in the unit. A Transitional Care Unit allows babies to receive special care on the postnatal ward, either with or without a preceding stay in the Neonatal Unit, and this reduces the separation of mother and baby. The Central Labour Suite has a complement of 16 beds which includes a purpose built Waterbirth suite and Family Bereavement Room. There were 3,200 births in 2009.

The Anaesthetic Department provides a 24-hour emergency cover for labour ward, 24-hour cover epidural service and five consultant anaesthetic sessions on labour ward.

Gynaecology

The Gynaecological Services provides complete inpatient including emergency admissions, day case and outpatient facilities. The philosophy of care for gynaecology is investigation of patients as an outpatient and of minimal surgical intervention. The advancement in endoscopic surgery and laparoscopic procedures has increased both day case surgery and procedures performed within the outpatient clinic. This has resulted in a reduction in the length of stay of patients. Specialist outpatient gynaecology services include Colposcopy, Fertility, Urogynaecology, Oncology, services to provide Termination of Pregnancy and Sterilisation and an Early Pregnancy Assessment Service. These specialist clinics, in addition to Minor Procedure clinics, allow complete investigation of the patient at initial referral visit. Rapid access clinics for early detection and diagnosis of gynaecological cancer have been introduced. Satellite outpatient gynaecology services are provided at Ellesmere Port Hospital.

Unscheduled Bleeding Whilst Taking Hormone Replacement Therapy (HRT)

What is ‘unscheduled bleeding’?

Hormone replacement therapy can cause irregular vaginal bleeding when it is first started. Unscheduled bleeding is vaginal bleeding that occurs after 6 months of being on HRT that is not linked to your period.

What causes unscheduled bleeding?

There can be several causes for this bleeding. It can be due to missing pills, patches or applications, your body not absorbing the hormones efficiently or being on the wrong form of HRT for you. It can also be caused by a thinned vaginal skin (called atrophic vaginitis), polyps in the womb or on the cervix (neck of the womb), or other abnormalities of the cervix or within the womb itself.

In some instances, bleeding can be due to cancer of the cervix or womb, but this is the case in only about 1 in 80 women who continue to have irregular bleeding after taking their HRT regularly for 6 months or more.

Why am I being referred?

Your Primary Care Clinician (e.g., GP or other health professional) has decided with you that you need a scan to help identify or rule out possible causes of your bleeding.  

What happens next?

You will be invited to attend a scan appointment, where you will have a Transvaginal Ultrasound Scan (TVUSS).

If you are still experiencing vaginal bleeding, the scan is still ok to go ahead.

At the appointment, a Sonographer will ask to place a small scanner inside the vagina to provide an accurate view of the cervix, womb, and ovaries. They will be looking for anything that may be causing the bleeding.

The test may be undertaken by a male or female Sonographer. Please ask upon arrival if you would like a female chaperone.

Will the test be painful?

The vaginal probe is small (less than the width of two fingers), and most women say it is only a little uncomfortable; similar to a cervical screening ‘smear’ test. However, there may be a little discomfort when the probe is moved around to ensure all areas are examined.

When will I get the results?

If the scan is normal, we will confirm this on the day, and you will be asked to book a review appointment with your GP to discuss possible changes to your HRT prescription.

You will be told if your scan shows something that requires further investigation but the Sonographer will not be able to give you a diagnosis during your appointment.  They will organise for your information to be reviewed by the Urgent Suspected Cancer Team and you will receive a further appointment to discuss the next tests required to diagnose the cause for your bleeding.

Your GP will be sent a copy of the scan report.

What do I need to do next?

It would be appreciated if you could make every effort to keep the appointment you have been given, however if you are unable to attend, or would like to rearrange, please use the telephone number provided on your scan appointment letter.

What if my symptoms worsen?

Please contact your GP surgery if your bleeding becomes heavier or more frequent.

Please ensure your contact details are up to date with your GP practice, including your phone numbers and your address.