ANSC November Update: St George and Sutherland

Early Pregnancy Assessment Service (EPAS)

Mon-Fri 7.30 am - 8.30 am (excluding public holidays)
Located in 1 West Gynaecology ward
Level 1, main building
Fax: 9113 3183
See flyer for more information

Women can be seen in EPAS for:

  • Bleeding in early pregnancy less than 20 weeks’ gestation
  • BHCG follow-up blood tests
    • To assess viability or monitor pregnancy of unknown location
  • Ectopic pregnancy, which is treated conservatively as an outpatient if stable and meets criteria (Needs repeat BHCG Day 4 & Day 7 then weekly following methotrexate until BHCG levels reach zero; Follow up in EPAS Day 5 & Day 8)
  • Follow up for ectopic and gestational trophoblastic disease
  • Management of mild - moderate hyperemesis
  • Non-viable pregnancy on ultrasound scan (Miscarriage, either threatened, missed or complete treated expectantly, medically or surgically)
  • Advice regarding exposure to infective agents or radiological procedures.

Referrals come from GPs, ED STG or TSH, and self-referrals.

Note:  

It is preferable if women come with copies of blood results, such as blood group and BHCG levels, as well as all ultrasounds attended with reports, and any significant medical history. Most importantly women must be stable - if heavy bleeding, uncontrolled pain or feeling unwell should present to ED, before presenting to the EPAS service. Recently the EPAS service has had numerous women attend without US or blood results that were available, including blood group. This affects the running time of the clinic, as staff are waiting for results to be faxed or re-taken and causes stress for the women waiting.

It is advised that GPs give the woman a copy of these results prior to referring the woman to attend, or fax directly to the clinic with a referral note (contact details above).


GP ANSC Protocol

The St George and Sutherland Hospitals GP ANSC Protocol has recently been updated and is now available on the CESPHN website. Please take the time to read the criteria for managing low risk women on the program, which is available here.

Please review the ‘Assess whether a woman may need low-dose aspirin treatment’ section on page 7. This recommends women meeting the criteria should be commenced on low dose aspirin (150mg) as soon as possible – before 16weeks pregnant is preferable. As some pregnant women may not attend the hospital booking appointment before this gestation, the GP should commence the recommended treatment.

Please note: In assessing the criteria, also include the ‘Risk of Pre-eclampsia’ assessment given on the Nuchal Translucency/12 week scan results. If the result is ‘high risk’ please commence aspirin as soon as possible.


Antenatal visits

Please review the ‘Subsequent antenatal visits and investigations section on page 8 of the protocol, which recommends the history and examination that is required.

Completion of the Antenatal Record card is required at each visit, including updating any investigation results and record of vaccinations given. Remind your women to carry the card at all times and have it completed at any and all consultations. Good communication is the essence of successful antenatal care.

At the 26-28 week blood test, include the antibody screen on all women. It has been noted on some results that the Ab screen had not been included. Anti D cannot be given unless the current Ab screen results are available. These women attend ANC at 28wks with blood results.


CPD events

CPD events with St George and Sutherland Hospitals are finished for this year. As 2018 is the second year of the ANSC triennium, if you require further points to remain on the ANSC program, please keep an eye out for the 2019 CESPHN education calendar early in the new year. At the end of 2019, GPs without the 12 CPD points required will be notified and their name will be removed from participating in the ANSC program. Exceptions are only for newly registered ANSC GPs within this triennium.


Invitation to participate in the Timing of Birth study: Translating evidence into practice in relation to induction of labour and planned caesarean section

This study will capture the experiences and attitudes of GPs in relation to planned caesarean sections (CS) and inductions of labour (IOL) through surveys methods, focus groups and interviews. The aim is to uncover and make sense of the perspectives, attitudes and experiences of GPs in relation to planned birth.

We invite all GPs to participate in this study by completing a survey here: Clinician Survey - for midwives, obstetricians and general practitioners

This study is part of a larger study that is making sense of clinical variation in relation to planned birth at maternity hospitals affiliated with South Eastern Sydney and South Western Sydney Local Health Districts – the Royal Hospital for Women, St George, Sutherland, Fairfield, Liverpool, Campbelltown, Bankstown-Lidcombe, and Bowral.

The Timing of Birth study is conducted by the Maternal, Newborn and Women’s Clinical Academic Group of The Sydney Partnership for Health, Education, Research and Enterprise (SPHERE). This partnership includes SESLHD, SWSLHD, as well as the University of Technology Sydney, University of NSW and Western Sydney University. Ethics approval has been received from SESLHD and SWSLHD, project number 18/169 (HREC/18/POWH/356).

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South Eastern Community Connect Services

South Eastern Community Connect offers a range of family services including:

  • Playgroups
  • Toy library
  • Out of school hours care
  • Family support program
  • Parenting programs and information sessions e.g. CPR, programs for dads, Triple P and English classes

Grandparents are also welcome to attend.

For more information visit https://www.secc.sydney/our-services/family-services/