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

UPDATE: ANSC GP Liaison Midwife

SLHD is currently recruiting a new GP Liaison Midwife for the RPA Women and Babies/Canterbury Hospital ANSC program.

During the recruitment period, GPs should note that routine clinical advice and support will continue to be available via the GP Liaison Midwife phoneline, 0425 230 662. Urgent clinical concerns should be directed to the on-call O&G registrar at either RPA or Canterbury Hospitals.

Now recruiting: RPA Hospital VMO (GP) – Obstetrics and Gynaecology

RPA Hospital is currently recruiting a Visiting Medical Officer (GP) – Obstetrics and Gynaecology. The primary purpose of the role is to provide high quality diagnostic and consultative specialty services in Women and Babies Ambulatory Care and to participate in teaching, research, quality improvement and administrative activities within RPAH as required.

For further information on the position and for details on how to apply please click here.
Application closing date: April 12^th 2021.

New RPA Communication strategy

To enhance communication with referring doctors, RPA has developed a new strategy for non-face to face consultations. This strategy has been circulated to all hospital staff. GPs are to note step 6 and contact hospital clerk if patient information is not being received. 

Strategy for Enhanced GP Communication for Non-Face to Face Consultations

1. Regular education of doctors and midwives of the importance of routine and timely communication with referring doctors.
2. Continued use of the Yellow Card for all face-to-face consultations.
3. When a non-face to face consultation occurs, documentation of relevant findings and plan will occur in PowerChart. This information will be automatically transferred into the pregnancy “Summary Report”.
4. The midwife or clinician seeing the patient will confirm contact details of the referring doctor or local GP.
5. A “Healthcare Professions Request Form” is completed and faxed to Medical records requesting the Summary Report +/- other results/ultrasound be sent to the identified GP.
6. Should the GP not receive any patient information, they can contact the Release of Information Clerk on 9515 6094, and the clerk will fax or electronically send the Summary Report.

New GP education case study series; Decreased Fetal Movements

A new education initiative in conjunction with the RPA Obstetrics and Gynaecology Department will be rolled out in the ANSC e-newsletter this year. Each newsletter will contain a case scenario on an elected topic area. 

Case scenario: 

35-year-old, Maria, Gravida 2, Para 1 presented to her GP with her first episode of decreased fetal movements at 38 weeks gestational age. Her first pregnancy resulted in a ventouse assisted vaginal birth of a 3.0kg baby. Her current pregnancy had progressed well with no antenatal issues. She denied feeling unwell, any vaginal loss or bleeding and reported painless tightenings. Her GP took vital signs and performed an abdominal examination. BP was normal at 112/65. Abdomen was palpated as a cephalic presentation with reduced fundal height of 35cm. Fetal heart rate of 145bpm.

What would you do next if you were Maria’s GP? Click on the link to see full case scenario.

RPA Fetal Medicine: Electric Ultrasound Reports now available on HealthLink. 

The Fetal Medicine Unit at RPA are now uploading fetal anomaly scan (FAS) and combined first trimester screening (cFTS) reports to HealthLink. 

If you have any issues accessing reports on HealthLink, please contact RPA Fetal Medicine Unit on 9515 6042 or rpafmu@health.nsw.gov.au. For other clinical requests or if you require a faxed report, please contact the Fetal Medicine Unit. 

Please note, this does not include non-invasive prenatal testing (NIPT) reports. 

RPA Pre-conception Clinic

The Pregnancy Planning Clinic in the Sydney Local Health District aims to optimise health prior to conception. The clinic is located in the Charles Perkins Centre adjacent to RPA Hospital and is designed for persons and couples considering pregnancy with:

1. Underweight or overweight/obesity
2. A chronic health condition such as cardiac or renal disease, Crohn’s disease, diabetes
3. A history of chronic long term medication use including substance use
4. A history of previous adverse pregnancy outcomes
5. A personal or family history of genetic or congenital abnormalities
6. A history of gestational diabetes
7. Lifestyle intervention advice to optimise fertility
8. Planning first pregnancy and >40 years

The clinic aims to provide care that will optimise health before pregnancy in order to improve maternal and fetal outcomes including detailed history taking, clinical examination, relevant investigations and referrals, and dietary and exercise advice. 

To refer women to the clinic please use the following details:

Where: Charles Perkins Centre, John Hopkins Drive

Refer patients by faxing patient information (patient details, past medical history, relevant clinical information and investigation findings) to 9562 5629. Please include clinic name in referral information, ‘Pregnancy Planning Clinic’. 

Contact (phone): 9562 5600/5607

RPA Pre-term Birth Clinic 

Preterm birth is the single greatest cause of death and disability in children up to five years of age in the developed world with increased risk of disease, cerebral haemorrhage, necrosis of the bowl and infection in the newborn periods. The risk further extends into later life, where children can be affected by cerebral palsy, chronic lung disease, deafness, blindness and learning and behavioural problems as well as into adulthood where individuals may develop metabolic syndrome, diabetes and heart disease.   

RPA has established a preterm birth clinic to provide high-risk obstetrics care in a multidisciplinary team. The clinic will be conducted on Friday afternoons in ambulatory care at the Fetal Medicine Unit. Depending on the course of their pregnancy and requests for antenatal care, women may remain in the clinic for the duration of their pregnancy or be discharged to another mode of care if appropriate.  

Referral criteria from General Practice: 

• Previous preterm birth at 24 to 36 weeks’ gestation   
• A pregnancy loss between 16+0 and 23+6 weeks’ gestation  
• Significant uterine anomaly  
• History of cone biopsy of the cervix or LLETZ procedure  
• Previous fully-dilated caesarean section 
• History of treatment for cervical shortening in a previous pregnancy (i.e. progesterone therapy, insertion of cervical cerclage or Arabin pessary) 

Where possible, women with a history of preterm birth or second trimester loss should be considered for a referral in the preconception period. This may facilitate intervention prenatally or early in a subsequent pregnancy.  

GPs wishing to refer to Pre-term clinic should fax the Obstetric Referral Form or referral letter to the ANSC FAX 9515 3454 stating request for referral to the Pre-term Clinic. Please note any relevant clinical details addressing referral criteria for the clinic. The GP Liaison Midwife and/or High Risk Clinic Midwife will review referrals and the hospital will get in touch with the woman to arrange appointment  

Canterbury Antenatal and Postnatal Service (CAPS)

Canterbury Antenatal & Postnatal Service (CAPS) provides Canterbury Families with the opportunity to have a known midwife for the duration of their pregnancy and early parenting journey. Evidence shows us that women value continuity of care from a known midwife most in the antenatal and postnatal periods. CAPS is designed with this evidence in mind. 

The CAPS midwives meet families at their first booking appointment and provide all of the antenatal care in collaboration with the medical team as required. The women then birth at Canterbury Hospital and are supported to return home as soon as is suitable after the birth of their baby. Their CAPS midwife then looks after the family’s postnatal needs at home for up to 14 days. The women are always very excited to show their new baby to the midwife who has cared for the baby in utero as it grew!

In the antenatal period, the CAPS midwives conduct appointments in the women’s homes as required however the emphasis is on meeting women at the local Child and Family centres in order to build the connection between the woman and the Child and Family Health Service. 

CAPS also work closely with the Paediatric and Obstetric teams at Canterbury to ensure that woman are receiving evidence based, collaborative care.

GPs or patients can phone or text the following number 0436 661 850 to make a booking. If possible, text message is best so the midwife can make contact when she is not with a patient herself.

Click here for CAPS flyer with further information

New Concord Hospital Midwifery Group Practice Service 

A new Midwifery Clinic offering maternity (pregnancy and baby) care for women will open in 2021. The Bulbuwul Mudjin Midwifery Clinic is located at Concord Hospital for women who live in the Concord area.

Bulbuwul Mudjin translates to ‘Strong Families’ in the local Aboriginal language. The clinic will provide a Midwifery Group Practice (MGP) model of care, supporting the development of strong families in the community.

The MGP model is a small team of midwives who support women through pregnancy, childbirth and provide care for the family in the first weeks after birth. 

Women in the Concord MGP will give birth at either RPA or Canterbury hospitals. There is no inpatient maternity unit or birthing unit at Concord Hospital.

GPs should advise women to contact the service via the details below if they are interested in this model of care. Please complete GP Referral Form. Provide your patient with a copy of the referral form and copies of recent relevant investigations and pathology to bring to their to first hospital visit.

Bulbuwul Mudjin Midwifery Clinic
Building 31, Concord Hospital
Hospital Road, Concord
P 9767 9021 

SLHD-ConcordMGP@health.nsw.gov.au

Professor Jon Hyett: Non-invasive prenatal screening CPD event

Join Professor Jon Hyett at this face-to-face CPD event on April 29^th. Professor Hyett will be discussing NIPT in Australia, highlighting the benefits and challenges in clinical practice. 

There is now a significant body of evidence confirming that NIPT is the most efficacious screening test for Down syndrome as well as other common forms of aneuploidy. 

The session will discuss a series of cases that show the value of NIPT and demonstrate how it is best embedded in clinical management. We shall also review discuss developments, such as genome wide NIPT and screening for rare autosomal trisomies that are likely of little diagnostic value and have the potential to reduce overall efficacy of this screening test.

The event is a networking opportunity for Antenatal Shared Care GPs in the region, and includes drinks and dinner. Please click link to see flyer and register to attend.