ANSC December 2022 Update: Royal Hospital for Women


Contact details for RHW

Email addressfor GP enquiries at RHW:

Antenatal Shared Care (ANSC) GP Liaison Midwife Chantelle du Boisee workdays are Monday and Tuesday 8.00am-6.00pm. (Please note these days have changed). Email –

For Clinical GP Advice line call 0417 995 153 (Monday – Friday 8.00-4.30). The mobile phone will be answered by the liaison midwife or the senior in charge midwife.

If you need to speak directly to the Obstetric doctors, please call ph.9382 6111 and ask the operator to page the on-call Obstetric Registrar for ANSC

The Obstetric Medicine Physician Registrar can be contacted for advice Monday-Friday during business hours by calling 9382 6111. Advise the operator to page the Registrar.

For more urgent 7 day /24hr advice, contact Delivery Suite ph. 0439 869 035 or 9382 6100 (from 20 weeks pregnancy).

National Preterm Birth Prevention Collaborative

RHW has joined the national preterm birth prevention collaborative with the aim to reduce the rate of preterm birth and early term birth in Australia by 20%. Please help RHW to reduce the rate by following the recommendations outlined by Dr Antonia Shand, the obstetrician who is leading the RHW preterm birth initiative.

Infectious Diseases In Pregnancy Clinic
Dr Antonia Shand leads the Infectious Diseases in Pregnancy clinic at RHW.  This clinic sees women with Syphilis, HIV, Hepatitis B and C, Cytomegalovirus (CMV) and toxoplasmosis infections in pregnancy. Obstetrics, midwifery, maternal fetal medicine, adult infectious diseases/virology/Paediatric infectious diseases and public health work together when required, to ensure best quality care for women and their children. The clinic is on alternative Monday afternoons in outpatients.  FAX all referrals addressed to Dr Antonia Shand to 9382 6118.

Updates And Reminders

  • Reminder for 20 week GP visit – Please give blood request referrals for 26-28 week bloods at the 20 week visit. See reminder of activities and considerations at the 20 week GP visit.
  • Normal Creatinine values in pregnancy are 30-70 mmol/L.   If the Creatine values are abnormal please contact the GP advice line or the Obstetric Registrar for advice.
  • Refer women and families from overseas with or without medicare, to Galuh Sapthari the RHW Cross Cultural Worker. For more details please see the information sheet. Galuh can be contacted Monday -Friday on 0439 510 697 or email
  • The Estimated Due date (EDD) is calculated by the midwife at the booking appointment using the EDD clinical business rule. If you have a concern or query regarding the EDD please contact the GP advice line to discuss.
  • Filling Out the Yellow Card Antenatal Record: Please encourage women to bring their yellow card to all ANSC GP and hospital appointments.
    • At each GP visit, document key clinical information on the yellow card including BP, weight, UA, fundal height, fetal movement, fetal heart rate with dopplar and any other relevant information including results and pathology tests ordered.
  • Obstetrician Consultant Dr Sarah Lyons is now leading the Preterm Birth Prevention clinic, OASIS and Mondays Obstetric Diabetes Clinic: Please refer to Dr Sarah Lyons when referring to these clinincs and fax the referral to 9382 6118
  • Perinatal Mental Health has a new email address. Email all referrals to:
  • Updated MFM referral form is available on the RHW websiteMaternal-Fetal Medicine | South Eastern Sydney Local Health District (
  • Contact the Fetus Line on 0437 537 448 to discuss the referral, with the MFM midwife. Complete all details on the referral form and include relevant ultrasound and blood results (including blood group).
  • Delivery Suite can accept referrals from GPs and women, with urgent obstetric medical concerns in the immediate 14 days following the birth.  Contact Delivery suite on 0439 869 035 or 9382 6100.
  • Antenatal Blood tests must be attended at the confirmation of the pregnancy.  Any pre-conception bloods will need to be repeated at the confirmation of pregnancy.
  • Please refer to Specialized Obstetric Ultrasound Practices for all pregnancy ultrasounds.  RHW ultrasound department accepts referrals for Third trimester ultrasounds.
  • If a woman’s GP is not available for a routine GP antenatal visit, please ensure the woman sees another RHW accredited GP at the practice. If an accredited GP is not available, telephone the Liaison midwife to organize a hospital appointment on 0417 995 153.
  • Maternity Antenatal and Postnatal Services (MAPS) and GP ANSC: A team of midwives who provide the woman with continuity of care during the pregnancy and in the early postnatal period, in collaboration with an RHW affiliated GP. During labour and birth the care is provided by RHW birth unit midwives.  If you have a woman interested in MAPS please contact the GP Liaison midwife.

Booking In Visit

Please advise women to book online via the RHW website at ~ 6 weeks gestation. The booking in visit will generally be attended between 14-16 weeks gestation.

If your patient needs a more urgent Obstetric/and or Obstetric Medicine Physician review, please fax the referral to 9382 6118.

 Please note these important changes with the booking process since COVID-19:

  • Booking visits are via telehealth video appointment.
  • The GP is NOT required to complete the yellow card as this will be completed by the booking in midwife. The card will be mailed directly to the woman after the booking is completed.
  • The GP needs to complete the entire RHW antenatal referral form. Please fax, together with antenatal pathology, ultrasound results and any other relevant results to RHW Outpatients Department prior to the booking visit. Fax: 9382 6118.
  • Documents for the booking visit can be emailed to (please send as one document)

NB: Following on from the booking visit all ongoing results must be given to the woman to bring to their next hospital visit. Please do not fax, mail or CC in any results unless you have urgent clinical concerns.

When emailing or faxing patients results please ensure the patients name appears on all pages.

If your patient has NOT been contacted within 2 weeks of lodging their online booking submission, please ask them to follow up on 9382 6206.

Ask The Royal:

The information contained in this column is written by Obstetricians, Medical Specialists and other Health Clinicians and is drawn from regular questions asked by GPs via the ANSC advice line.

Ron Fleisher – RHW Genetic Counsellor will update on What’s new in NIPT.

Gestational Diabetes Mellitus (GDM)

There is a new patient educational letter for women, explaining why screening for gestational diabetes is recommended.

Please be aware that some pathology labs use different reference ranges for diagnosing GDM. RHW use the ADIPS criteria for diagnosing GDM which is as follows:

FASTING >5.1 mmol/L

1 HOUR >10 mmol/L

2 HOUR >8.5 mmol/L

If the following tests are incidentally performed at any stage in pregnancy PRIOR to OGTT and show the following results, do NOT perform OGTT, but refer as diagnostic of GDM or DM.

Fasting BGL:   (< 13 weeks gestation) ≥ 6.1mmol/L* OR

                         (≥ 13 weeks gestation) ≥ 5.1mmol/L

Random BGL ≥ 11.1mmol/L (i.e. beyond 2 hours postprandial)

* if OGTT or fasting BGL is performed < 13 weeks gestation and fasting BGL 5.1-6.0 mmol/L, this may be physiological and may require further evaluation. Discuss with, or refer to, DE/Diabetes Team for further advice

For further information you can review this helpful flowchart for screening, diagnosing and referring GDM and the GDM Screening and Management Policy

Referral Process after a diagnosis of GDM

If you have a patient diagnosed with GDM, please contact the Diabetes Educator within one week of the GDM diagnosis on (02) 9382 6010 or at

Please address the referral to Prof. S Lowe/Dr S M Lau/Dr A Beech/Dr H Barrett and attach the pathology results. Fax the referral and results to 9382 6118.

Perinatal Loss Service At RHW

The Perinatal Loss Service at the Royal Hospital for Women is a service that supports families experiencing pregnancy loss from 18 weeks gestation. This loss may be a miscarriage, stillbirth, a termination of pregnancy for abnormality or a neonatal death.

The Perinatal Loss team comprises a specialist obstetrician, a bereavement midwife and a named social worker, who coordinate care with genetic counsellors, neonatologists, perinatal mental health, chaplains as required.

The Perinatal Loss Service offers individualised care to these women and families through practical, emotional support and will offer ongoing contact in the early loss period and then follow up in Perinatal Loss Clinic to review results of autopsy, or other investigations and plan subsequent pregnancy management.

The “Living with Loss” program is an online support program offered to parents following a perinatal loss. This evidence based program has been co-designed by parents and the Stillbirth CRE (Centre of Research Excellence) and aims to assist parents in navigating their grief and find coping strategies to help bereaved parents manage the future without their baby.

For further information about the Perinatal Loss Service please contact the bereavement midwife at or by calling 9382 6007

Medical Disorders In Pregnancy Service

Referrals to Obstetric Medicine Physicians at the Medical Disorders in Pregnancy Clinic must be addressed to Professor Sandra Lowe/Dr Amanda Beech/Dr Helen Barrett. The patient will be contacted directly to arrange an appointment only after the referral has been received. Please fax referrals to 9382 6118.

Hyperemesis Gravidarum Initiative

New Policy released from NSW Health on Nausea and Vomiting in Pregnancy. See attached link –

Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (

Accessing Local Operating Procedures (LOP’s) NOW KNOWN AS Clinical Business Rules

You can access Clinical Business Rules at RHW here.

Important and helpful Clinical Business Rule reminders: