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

Objective. To introduce a pregnancy confirmation clinic as part of antenatal care and to determine whether this would alter the gestat:!-0nal age at which patients commence antenatal care.Setting. Three municipal antenatal clinics in Atteridgeville and Central Pretoria.Method. A pregnancy confirmation clinic was set up at three sites. At the clinic any woman wishing to confirm whether she was pregnant was offered a urine [3-HCG test. If this test was positive, on-site testing for syphilis, anaemia and rhesus status, dipstick testing of the urine, clinical examination and ultrasound examination were performed. Women with abnormal test results were commenced on appropriate treatment immediately and women requiring further medical care or investigation were referred appropriately.Results. The study recruited 382 women, 145 of whom were defaulters from contraception. Half of the women (191) had a positive pregnancy test. The mean presenting gestational age was 12 weeks 4 days (standard deviation 5 weeks, range 5 weeks - 25 weeks 2 days). Treatable conditions with the potential to influence pregnancy outcome were identified in 37 of the pregnant women (19.4%) Forty-three of the pregnant women intended to terminate the pregnancy.Conclusion. It is possible to shift the commencement of antenatal care to an earlier gestational age.