Pelvic pain referral checklist

Urgency tier

• Immediate ED/gynecology assessment for suspected ectopic pregnancy, torsion, peritonitis, severe escalating pain or heavy bleeding; do not wait for instability.
• Hospital assessment for PID with pregnancy, severe illness, possible abscess or inability to tolerate treatment; reassess nonresponse after 2-3 days of outpatient treatment.
• Routine referral for stable chronic pelvic pain requiring specialist input.

Minimum pre-referral workup

• Emergency transfer must not wait for completion of this checklist.
• Pain chronology, cycle relation, and associated urinary/GI symptoms.
• Pregnancy risk evaluation and bleeding pattern review.
• Focused exam findings and initial tests performed.

Referral packet checklist

• Structured symptom profile and red-flag findings.
• Investigation summary and response to first-line care.
• Relevant history, medications, and comorbidities.

Pre-referral optimization tasks

• Provide return precautions for worsening pain, fever, or bleeding.
• Continue interim symptom management and reassessment.
• Document specific specialist questions for targeted review.

References

• PHAC Pelvic inflammatory disease (partial update June 2026) (opens in a new tab)
• Emergency Care BC Acute pelvic pain: assessment and disposition (2024) (opens in a new tab)

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