Early pregnancy complications are one of the most common reasons for women of reproductive age seeking medical help. Many pregnancies are complicated by pain and/or bleeding, which often causes concern because of a perceived risk of miscarriage. A comprehensive service with easy and fast access needs to be provided for women in early pregnancy. An initial assessment to reach a correct diagnosis is carried out, and diagnostic tests are instigated. Follow-up is vital, and for those women who have suffered pregnancy loss, offering counselling and support is another important role for an early pregnancy unit. With the advent of computer databases, a paperless clinic can be a key element in the efficient running of an early pregnancy unit. It is important that the unit has multidisciplinary and trained staff, access to laboratory tests, a gynaecology ward and operating theatre, in case of direct admissions, and facilities for resuscitation.

Scientific advancements have had a profound impact on preconception risk assessment, prenatal diagnostic capabilities, and early intervention. Increased use of sophisticated ultrasound scans and laboratory technology, including the application of recent developments in gene mapping and prenatal blood, tissue, amniotic fluid testing, has resulted in dramatic advancements in antepartum testing. Legal events indicate that the failure to timely utilize technology appropriately to establish the diagnosis of a fetal problem earlier when treatment or termination may have avoided the outcome, is a sufficient and legal recognizable injury for the parents. A physician considering a diagnosis of ectopic pregnancy must be careful to elicit both positive and negative historic data that might support an increased risk of ectopic pregnancy. Conducting advanced scanning procedures is potentially hazardous from a legal point of view when the personnel involved have limited expertise or limited exposure to high-risk conditions.