ANSC June Update: Royal Hospital for Women

 

New contact details for becoming affiliated with RHW for antenatal shared care

All enquiries related to becoming affiliated with RHW for antenatal shared care should be directed to Jane Miller of Central and Eastern Sydney PHN.  Jane’s details are as follows: 

Jane Miller 

Maternal and Child Health Program Officer (Monday, Wednesday and Thursday) 

Central and Eastern Sydney PHN 

Ph: 1300 986 991   Direct:  9304 8643 

j.miller@cesphn.com.au

The next antenatal shared care intake meeting is Saturday 9th November 2019. 

 

New ANSC Liaison Midwife

Chantelle du Boisee is the newly appointed liaison midwife replacing Julie Davis. Chantelle has been a midwife at RHW for 20 years and has worked in various roles at the hospital including midwifery clinics within the GPSC program, postnatal ward, antenatal clinical midwifery educator and infection control.

Contact details are 9382 6016 or 0417 995 153 or Email Chantelle.DuBoisee@health.nsw.gov.au

 

Antenatal resources

The following resources are available to order through Stream Solutions.

Please contact Stream Solutions to set up an account on 1300 786 075 or via email StreamDirectHelpdesk@stream.net.au

Having a Baby book (Product Code: KF110001),free of charge

Antenatal Yellow Cards (Product Code: NH612060), free of charge

Antenatal Referral forms (Product Code: S0741),$24. 26 per pad

Stream Solutions do have a minimum order requirement and will charge a postage & handling fee. 

 

New antenatal schedule of visits

In alignment with the Clinical Practice Guidelines: Pregnancy Care, 2018 edition - there have been changes to the number of visits and the order in which women share their antenatal care between RHW and their GP. These will be effective from 1 January 2019. Please refer to list below:

Please refer to list below:

  • 6 - 12 weeks (GP)
  • Booking visit 14 – 16 weeks gestation (RHW)
  • 20 weeks (GP)  *
  • 26 weeks (RHW)
  • 29 weeks (GP)  *
  • 31 weeks (RHW)ANTI-D GIVEN TO RH NEGATIVE WOMEN
  • 34 weeks (GP)
  • 36 weeks (RHW)ANTI-D GIVEN TO RH NEGATIVE WOMEN
  • 38 weeks (GP)
  • 39 weeks onwards (RHW)
  • 6 weeks postpartum  (GP)

* Please remember to check results and act on them accordingly at these appointments (morphology results and blood results) 

 

New GP antenatal shared care brochures and updated protocol summary

We are in the process of mailing out of brochures and protocol summaries to all GPs. Please see the links below for the updated Protocol Summary.

RHW website or

CESPHN website

 

Screening for gestational diabetes

Further to the previous newsletters, there still appears to be some confusion about screening and diagnosis for Gestational Diabetes. Women with the following high risk factors need to be screened between 12 – 14 weeks pregnant:

✓ Ethnicity: Aboriginal/Torres Strait Islander, Asian, South Asian, Pacific Islander, Maori, Middle Eastern, Non-white African

✓ Insulin Resistance e.g. associated with PCOS

✓ Maternal Age ≥ 40 years

✓ Medications e.g. corticosteroids, antipsychotics

✓ BMI ≥ 30 at preconception or initial booking

✓ Previous adverse pregnancy outcome suggestive of undiagnosed GDM e.g. shoulder dystocia, unexplained stillbirth

✓ Previous baby with birth weight >4.5kg

✓ Previous GDM

✓ Strong family history diabetes (1st degree relative with diabetes, sister with GDM)

If the early screening test is negative, the woman still need to repeat the 75gm GTT again between 26 – 28 weeks.

If the early screening test is positive, please contact Diabetes Educator as below. The woman does not need to repeat at 26-28 weeks.

Refer within 1 week of diagnosis to Diabetes Educator, email preferred: SESLHD-RoyalHospitalforWomen-DiabetesServices@health.nsw.gov.au
or Fax to: 9382 6118; Phone: 9382 6010 Please include:

✓ Copy of 75g OGTT results, weeks of gestation, EDC, relevant medical history, reason for referral

✓ Patient current phone number

✓ Indicate if interpreter required

Diabetes Educator will contact the woman within a few days of receipt of referral and will arrange appointments with Diabetic Educator, Dietician and Endocrinologist.

Please click here for the RHW easy to follow Flowchart for Screening, Diagnosis and Referral of Gestational Diabetes Mellitus (GDM).

Also see here for the RHW Guideline for Screening, Diagnosis and Referral of Gestational Diabetes Mellitus (GDM).

 

Antenatal pathology and ultrasound screening

When ordering antenatal blood screening please follow the RHW GP Antenatal Shared Care Protocol. Mumps, measles and thyroid function tests are not routine antenatal bloods. Only order thyroid function tests if indicated, as per protocol summary.

Antenatal blood screening needs to be done for current pregnancies. There have been a number of incidents recently whereby antenatal blood screening has not been ordered by the GP either because:

1. The woman has gone through IVF and antenatal bloods were done pre-pregnancy; or

2. The woman has had antenatal blood screening in a previous pregnancy which resulted in a miscarriage but then fell pregnant within 3 months of miscarriage.

Ensure that all antenatal bloods ordered are for the current pregnancy.

Provide referral for morphology ultrasound after review of early genetic screening. A 12 week structural ultrasound is required in addition to NIPS.

Advise women to do 26 - 28 week bloods after 26 weeks gestation.