ANSC March Update: RPA Women and Babies

ANSC resource updates 

  1. ANSC GP protocol has been updated to include: Consider an STI check. Recommend HVS PCR or first stream urine PCR chlamydia for women < 29 years or with new partner as part of early pregnancy assessment 
  2. Nausea and Vomiting resource has been reviewed and updated.
  3. RPA Antenatal Thyroid Referral Form has been updated. This form (and others) are available to download into your clinical software. Visit Bookings, referral process, contacts to view how to import template.

GPs are encouraged to access ANSC resources via CESPHN website - Resources for GPs. If you would like a hard copy of these resources, please contact Karen Wheeler.

Help us in shaping our children’s future: a short survey on preconception health

Preconception health focuses on taking steps now to protect the health of a baby in the future. The Charles Perkins Centre, University of Sydney,  is seeking the collaboration of GPs in completing a survey on current practice and potential service needs in preconception health. This survey will take five to 10 minutes. Your participation is greatly appreciated. 

You may open the survey in your web browser by clicking the link or visiting https://redcap.sswahs.nsw.gov.au/surveys/?s=AYFRMWFHE8

For more information, please contact Dr Adrienne Gordon on 8627 4039 or Dr Nathalie Kizirian on 8627 4039  

Clinical assessment and examination

All women should have a directed clinical assessment at each antenatal visit, with a focus on general well-being and early diagnosis of pregnancy complications. 

  • Fetal movements: Important to regularly enquire to ascertain fetal wellbeing. Any maternal concern of decreased fetal movements overrides any definition based on numbers. Any concerns regarding reduced or absent fetal movements contact O&G Registrar at relevant hospital or Delivery Ward (RPA) ph. 9515 8444 or Birthing Unit (TCH) ph. 9878 0555 
  • Patient brochure: Pregnancy: Your baby’s movements and what they mean 
  • Fetal heart rate: Assessment with fetal doppler is recommended. Listen for at least one minute. Normal rate~ 110-160/minute.
  • Inspection: Size of uterus, shape of uterus, skin changes, contour of abdomen
    • Measure symphysial-fundal height: Record measurements on antenatal card
    • If +/- 3cm discrepancy between fundal height and gestation or no growth over two week period make hospital referral 
    • Palpation: Lie, Presentation, Position, Attitude
  • Measure blood pressure. Attend at each visit, plus assess woman for any neurological symptoms (headache,visual disturbance, vomiting/nausea) and/or significant epigastric or right upper quadrant pain. Hypertension definition: systolic ≥140mmHg and/or diastolic ≥ 90 mmHg 
  • Urgent assessment: Contact relevant hospital O&G Registrar on call
  • Semi-urgent assessment: RPA Fetal Medicine Antenatal Assessment Day Stay Unit or Hypertension Clinic. Fax referral to ANC 9515 3454 
  • Canterbury: Rosalie Nunn Midwifery Nurse practitioner 9787 0000 pager # 82211 or Clare Jordan GP Liaison Midwife ph. 0425 230 662 

Scheduling GP Antenatal Shared Care (ANSC) visits

When scheduling a woman’s ANSC visit, please be mindful of her routine hospital visits as per ANSC Protocol i.e ~ 14wks (booking), 20wks (obstetrician review), 30wks, 37wks. There have been occasions when a woman has attended her routine hospital visit and then been booked for a GP visit that afternoon or the next day. 

Child and Family Support Services 

Did you know that SLHD provides a free Sustained Health Home Visiting Program to provide extra support and promote the health and development of mothers, families, and their children?

What does the service provide?

  • Up to 25 home visits by a Child and Family Health Nurse, for children < 2 years of age
  • Phone contact with nurse between visits if needed
  • Links and information about other family support services
  • Information on feeding, crying, and settling
  • Support adjusting to the baby
  • Toddler learning and development
  • Interpreting services available 
  • Note: Services are available in addition to normal ante-natal care

What is the referral criteria? 

Health care professionals can refer if one or more of the following risk factors are present:

  • Current parental drug and alcohol misuse
  • Unstable mental health
  • Current domestic violence
  • Child protection issues
  • Antenatal or postnatal notification where a woman has been referred to Family and Community Services
  • Clinician judgement
  • Young mother < 20 years of age
  • Edinburgh Depression Scale of ≥ 10
  • Late antenatal care
  • Adjustment to parenting issues
  • Mild to moderate anxiety or depression
  • Unstable housing
  • Financial stress
  • Partner unemployed
  • Child or parent with chronic illness
  • Refugee status, recent migrant, poor English skills  

Note: Self-referral not available

Antenatal referrals deliver the best outcome for clients and they are more inclined to stay on the program longer.

What is the referral process?  

  • For general enquiries: hfhcintake@sswahs.nsw.gov.au
  • Refer via fax: 9750 9440 
  • Attention: Healthy Families Healthy Children Sustained Health Home Visiting Team

Note: Healthy Family, Healthy Children Team will determine acceptance into the program on a case by case basis.

For more information, see:

RPA Ultrasound forms

The new RPA Ultrasound forms are now available. Please contact Clare Jordan GP Liaison Midwife on 0425 230 662 if you require copies.