ANSC May Update: The Royal Hospital for Women

Is your knowledge up to date?

Over the past 12 months there have been cases where either the wrong test has been ordered and / or not ordered correctly.

Screening for gestational diabetes

Please note that the 50 GCT is no longer used as a screening tool for GDM. All women are to have fasting 75 GTT. All three samples (fasting, one hour and two hour) should be requested for clarity. Please click here for a flowchart for screening, diagnosis and referral of Gestational Diabetes Mellitus (GDM) at RHW.

Screening for thalaessamia

Please click here for the criteria for Thalassaemia screening. Please note that partners also need to be screened at the same time.

Antenatal blood screening

Always remember to order antenatal bloods when seeing a pregnant woman for the first time, regardless if they have already been attended pre-conceptually. Antenatal blood screening needs to be attended in every pregnancy.

Pregnant PCOS patient recruitment

The RHW are looking to recruit 40 pregnant women with polycystic ovarian syndrome (PCOS) for a study aiming to evaluate the role of continuous blood glucose monitoring (CBGM) among that population. Please see this flyer for further information and contact details.

Breastfeeding education and support

Lactation consultants at The Royal Hospital for Women are available to provide support and information for GPs and their patients. Click here for lactation consultant contact details and other support services. 

Non-Invasive Prenatal Screening (NIPS) blood test

We receive many enquiries as to the best timing of the NIPS. Our usual advice is for women to start with the combined first trimester screen and use this to guide their decision regarding further screening or diagnostic testing. An ultrasound at this gestation is important as it determines viability, can diagnose multiple pregnancies, and can identify structural anomalies. If all looks well on ultrasound at 12 weeks, women may like to pursue the NIPS for additional reassurance regarding their chance of Down Syndrome. However, if concerns arise at the nuchal scan (e.g. increased nuchal translucency measurement or other structural anomalies) following counselling women may consider a diagnostic test, such as CVS or amniocentesis, as the NIPS is a screening test and cannot provide a diagnosis. In the context of a structural anomaly a diagnostic test may provide more clinically relevant information than the NIPS, as a chromosome microarray is now routinely performed on all CVS and amniocentesis samples.

If women request an early NIPS (i.e. from 10 weeks gestation) we recommend an ultrasound at the time of blood collection, followed by a structural ultrasound at 11-14 weeks. The structural ultrasound can identify anomalies not detected by the NIPS, for example, neural tube defects.

Guidelines regarding the NIPS may change if a Medicare rebate becomes available in the future.

Click through to access the Royal Hospital for Women local operating procedures regarding Genetic Counselling and First Trimester Screening

Online CPD – First trimester screening including NIPT

The Centre for Genetics Education has updated the First Trimester Screening (FTS) online activity for GPs. This free online activity is designed to assist GPs:

  • develop strategies to discuss screening, including NIPT
  • increase knowledge of appropriate and evidence-based information
  • facilitate discussion for informed choice with women and their partners

Click here to access a copy of the activity flyer.