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Antenatal and Maternity

Find assessment and management information on Antenatal and Maternity conditions at:

Emergency Immediate transfer to the Emergency Department

If any of the following are present or suspected, please call the Obstetric Registrar/Obstetrician on call for emergent medical advice, and be advised by them as to where to direct the patient for urgent review (via ambulance if necessary).

A written referral should be forwarded as directed by the hospital clinician.  This referral is separate from the Antenatal referral which is required to book the patient in to the Maternity Service.

First Trimester

  • Suspected or proven ectopic pregnancy
  • Heavy bleeding/severe pain (haemodynamically unstable) +/- fever (suspicion of sepsis)
  • Threatened or incomplete miscarriage if haemodynamically unstable
  • Intractable vomiting

Post first trimester

  • Heavy bleeding/severe pain (haemodynamically unstable) +/- fever (suspicion of sepsis)
  • Threatened or incomplete miscarriage 
  • Threatened preterm labour
  • Pre-term rupture of membranes
  • Evidence of cervical incompetence
  • Intractable vomiting
  • Hypertension equal to or greater than 140/90 mm Hg
  • Severe headaches or visual disturbances
  • Suspected pre-eclampsia presenting with  hypertension systolic blood pressure equal to or greater than 140 mmHg and/or diastolic blood pressure equal to or greater than 90 mmHg and one or more of the following organ/system features related to the mother and/or fetus:
    • Renal
      • random urine protein to creatinine ratio greater than or equal to 30mg/mmol from an uncontaminated specimen (proteinuria)
      • Serum or plasma creatinine greater than or equal to 90 micromol/L or
      • oliguria (less than 80 mL/4hours or 500 mL/24 hours)
    • Haematological
      • thrombocytopenia (platelets under 150 x 109/L)
      • haemolysis (schistocytes or red cell fragments on blood film, raised bilirubin, raised lactate dehydrogenase (LDH), decreased haptoglobin)
      • disseminated intravascular coagulation (DIC)
    • Liver
      • new onset of raised transaminases (over 40 IU/L) with or without epigastric or right upper quadrant pain
    • Neurological
      • headache
      • persistent visual disturbances (photopsia, scotomata, cortical blindness, retinal vasospasm)
      • hyperreflexia with sustained clonus
      • convulsions (eclampsia)
      • stroke
    • Pulmonary
      • pulmonary oedema
    • Uteroplacental
      • fetal growth restriction (FGR)
      • suspected fetal compromise
      • abnormal umbilical artery Doppler wave form analysis
      • stillbirth
  • If gestational age is 23-32 weeks or fetal weight is less than 1500grams then contact local service as referral for emergency treatment may be directed to a level 6 maternity service for obstetric assessment
  • Seizures or unexplained syncope
  • Acute mental health concern needing to be seen by acute mental health service or psychiatric emergency centre. 
  • Abdominal trauma – GP check with maternity booking hospital level of care required
  • Any concern regarding fetal growth requires confirmation with ultrasound (if available) and referral to maternity service as indicated. 
  • Change in fetal movement pattern
  • Suspected or confirmed fetal death in utero
  • Any other significant concern

Gestational Diabetes Mellitus

  • Diabetic ketoacidosis
  • Diabetes and severe vomiting
  • Acute severe hyperglycaemia
  • Acute severe hypoglycaemia

A list of obstetric emergency referral criteria and contacts are available on the Brisbane South Antenatal Shared Care Summary

If you believe your patient requires immediate attention please phone 000 or refer your patient to the emergency department.

Are you referring to the right service?

Changes to the Antenatal schedule of visits may be recommended during the Covid-19 Pandemic, with some appointments preceded or replaced by Telehealth options. Please ensure all telephone contact details are current on referrals, and refer as early as practicable, so optimal planning for safe antenatal care can occur.  

Queensland clinical guidelines - Maternity care for mothers and babies during the COVID-19 pandemic

Metro South Health has Maternity services located at Redland, Logan and Beaudesert Hospitals

All women who live locally in the Beaudesert Hospital area can be referred to the Beaudesert Antenatal Clinic (independent of pregnancy complication risk).  Triage will be undertaken to enlist care from other higher level services/other specialties as required, but some of the pregnancy and postnatal care may still be provided locally

Early Pregnancy Assessment Clinic is available at Logan Hospital only with an Early Pregnancy Review Clinic available at Redland Hospital (only after discussion with the on-call Obstetrician/Registrar).  For women in the Beaudesert Hospital area who require urgent assessment please phone the On-Call GP Obstetrician 5541 9174 or refer to the Emergency Department 

Termination of Pregnancy (TOP) For advice please refer to  Gynaecology- Termination of Pregnancy

Urgent referrals Arranging urgent review

A list of urgent referral criteria and contacts are available on the Brisbane South Antenatal Shared Care Summary

If there are identified pre-existing complications or conditions at the initial assessment, identify a referral as URGENT and clearly state the reason for urgent review.  The referral will be triaged by the booking hospital and consideration given to any relevant complication or conditions when planning care.
If a complication or condition requiring urgent specialist review develops during the course of a pregnancy for a woman already booked at a Metro South Maternity Service, please contact the relevant local service, and forward any referral back for care to the hospital  (not the Central Referral Hub). Contacts as per Antenatal Shared Care Summary above.

Out of scope services

Routine ultrasound scans (Dating, Nuchal Translucency and Morphology) are required to be booked with private providers

Notes

  • Please note that where appropriate and where available, the referral may also be linked-in with an associated public allied health and/or nursing service. 
  • A change in patient circumstance (such as condition deteriorating) may affect the urgency categorisation and should be communicated as soon as possible.
  • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Metro South Health is responsible for providing public health services to the people who reside within its boundaries.  Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

 

Metro South Health GP Maternity Share Care Education Bridging Program 

Are you looking to be aligned to provide Maternity Share Care across all Brisbane South Maternity Services? In partnership with Brisbane South PHN (BSPHN), Metro South Health (MSH) is pleased to offer GPs enrolment in the MSH GP Maternity Share Care Education Online Bridging Program. Please email GPLO Maternity Share Care for further information.
 

Last updated 29 November 2023