ANSC June 2021 Update: RPA Women and Babies/Canterbury Hospital

GP Liaison Midwife

Amanda Forti has commenced a temporary appointment as GP Liaison Midwife for RPA Women and Babies and Canterbury Hospital Antenatal Shared Care. Amanda brings a wealth of experience to the role having worked at RPA Women and Babies as the Clinical Midwife Consultant for high-risk pregnancy since 2017.

Amanda’s work hours are Monday to Friday 8-4:30. Amanda is contactable via phone or text on 0425 230 662, or email amanda.forti@health.nsw.gov.au

For urgent clinical concerns please contact the on-call O&G Registrar through switch at the relevant hospital: RPA 9515 6111, Canterbury 9787 0000  

 

Return to face-to-face hospital antenatal visits

RPA Women and Babies has returned to face-to-face visits for all antenatal hospital visits. If a woman is concerned about attending the hospital and declines a face-to-face appointment, she may request a telehealth consult. 

We acknowledge that there has been some replication of antenatal yellow cards by GPs and hospital staff due to hospital telehealth consultations. Some women may have 2 yellow cards, please update one card at all antenatal visits.

As all antenatal visits have now returned to face-to-face, we encourage GPs to commence yellow cards at a woman’s first antenatal visit and please remind women to take their yellow cards to all antenatal appointments at both the hospital and GP.

 

General reminder – key content for referral forms

Could GPs please ensure all relevant clinical history and key content is included on hospital referral forms. This includes LNMP/EDC (preferred)/current gestation.

This information is highly important for triaging referral forms and quickly processing new patients.

Please also include all relevant;

  • Obstetric history including parity
  • Medical conditions (including specialist name/location)
  • Pre-existing gynaecological disorders (including previous treatments)
  • Other conditions/considerations, eg. Psychosocial
  • Medications (name/dose/frequency)
  • Antenatal investigations with necessary results attached)

RPA Women and Babies/Canterbury Hospital referral forms can be found on the CESPHN webpage and on Sydney Healthpathways.

 

RPA Obstetrics and Gynaecology Department GP education series: Hypertension and pre-eclampsia

Case scenario: A healthy 28-year-old female, Amy, Gravida 2 Parity 1, presents to her GP at 34 weeks’ gestation complaining of a 3 day history of severe headaches and blurry vision. She reports good fetal movements with no vaginal loss. GP took vital signs with BP measuring 160/100. Examination revealed a soft non-tender abdomen with hyper-reflexia with 2 beats of clonus. Urinalysis shows proteinuria 2+. Amy’s GP refers her to the delivery ward for further blood tests and assessment.

What would you do next if you were Amy’s GP? Click on the link to   pdf see full case scenario. (226 KB)

 

RPA Fertility Clinic: Low-Cost IVF Services

RPA is participating in the NSW Health Affordable IVF Initiative, providing low-cost IVF services to people who need it across NSW. The RPA Fertility Unit is now running an increased capacity with treatment for suitable patients available within a few weeks of their first clinic visit.

The RPA Fertility Unit has also partnered with Genea Elements to provide affordable IVF services to patients at their Bella Vista clinic in accordance with the NSW IVF Initiative. This extends the provision of low-cost IVF treatment to patients within the Hills District region.

The RPA Fertility Unit offers a Recurrent Miscarriage Clinic and a Reproductive Medicine Clinic. Further information and referral pathways can be found through HealthPathways or on the SLHD Fertility webpage - https://www.slhd.nsw.gov.au/rpa/fertility/news.html

Appointments to the Fertility Clinic can be made by calling the RPA Women and Babies Outpatients Department on 02 9515 7101. Please ensure that you have a valid GP referral when presenting to the clinic.

Access the RPA Fertility Unit’s Referral page on HealthPathways: ‘Fertility Assessment’.

 

First trimester screening and Non-Invasive Prenatal Testing (NIPT) for pregnant women

NIPT through analysis of cell free DNA is now widely used in the general population. There is an increasing body of evidence that confirms this as the most efficacious screening test for Down syndrome and other common forms of aneuploidy. The range of applications of NIPT has continued to develop, the test can now be applied to twin pregnancies and has been shown to be effective in detecting conditions such as triploidy and the microdeletion 22q11.2.

The reproductive genomics services available within RPA Women and Babies now include three NIPT clinics each week (Tuesday-Thursday). Genetic carrier screening is now offered with tests adapted to a limited number (Cystic Fibrosis, Fragile X, Spinal Muscular Atrophy and Duchenne Muscular Dystrophy) or a larger range of conditions.

As NIPT is not funded within Australian health services, combined first trimester screening (cFTS) is offered using ultrasound and biochemistry as the primary screening tool within the hospital – however we are finding more women want to have an NIPT test as well. We can either use NIPT to screen instead of cFTS (from 10 weeks gestation) or in a contingent model after cFTS.

The cost to patients of the basic panel (trisomies 21, 18, 13, triploidy and sex chromosome anomalies) is $350 directly payable to the laboratory. Screening for del22q11.2 is an additional $40. There are no additional charges for pre- and post-test counselling or for phlebotomy. 

NIPT appointments involve patient review by a Reproductive Genomics Midwife counsellor, a scan (if needed) and blood test. GP referrals can be made using the standard ultrasound form (request NIPT test and scan if required). A copy of the results will be issued to the referring doctor.

For further information about the test please contact Dr Nasrin Javid on 0448 333 516 or email: Nasrin.Javid@health.nsw.gov.au

For bookings please email rpafmu@health.nsw.gov.au