Every Week Counts – National Preterm Birth Prevention Collaborative
RPA has joined the “Every Week Counts – National Preterm Birth Prevention Collaborative” which has been established to safely reduce the rate of preterm and early term birth by 20% across participating maternity services by March 2024. This reduction in preterm and early term birth is anticipated to have a dramatic impact on the health outcomes of women and babies, as well as saving millions in avoidable costs for new-born care and education service delivery.
The strategies proposed by the Collaborative to safely reduce the rate include:
No pregnancy to be ended until at least 39 weeks, unless there is obstetric or medical justification
Measurement of the length of the cervix at all mid-pregnancy scans
Use of natural vaginal progesterone if the length of the cervix is less than 25mm
If the length of the cervix is less than 10mm, consider cerclage or progesterone
Use of vaginal progesterone if you have a prior history of spontaneous preterm birth
Women who smoke should be identified and offered Quitline support
To access continuity of care from a known midwife during pregnancy where possible
RPA has a preterm birth (PTB) clinic which was established in 2020 to facilitate the care of women with a known risk of PTB, such as a history of PTB or cervical surgery. To further enhance the identification of women at risk of PTB, we are asking that GP’s request a transvaginal cervical length when referring women for a morphology ultrasound scan. Cervical surveillance will identify women with a short cervix, who can then be referred into the RPA PTB Clinic for their pregnancy care.
As per current practice, if the GP’s have any questions, they can contact the GPSC Clinical Midwife Consultant’s mobile for advice/assistance.
Discharge summaries on MyHealthRecord ANSC GPs are reminded that hospital discharge summaries are available via their patient’s MyHealthRecord. This includes ED presentations, EPAS admissions and well as postnatal discharge summaries. Summaries are uploaded to MyHealthRecord within 24 hours of discharge.
If you are having trouble accessing discharge summaries, please contact the GP Shared Care Midwife on 0425 230 662 (Monday to Friday 8am-4:30pm).
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, fundal height, fetal movement, fetal heart rate and any other relevant information including results and pathology tests ordered.
HealthLink Smartform E-Referral to RPAH Women and Babies Services
GPs are now able to use HealthLink SmartForms from their practice software or the HealthLink portal to launch e-Referrals to the following services:
For GPs without Best Practice, Genie or Medical Director practice systems, referrals can be lodged using the HealthLink portal, or via fax using the new fax coversheet which enables digitisation of your faxed referral.
In addition to results being sent via Healthlink with referral forms, GPs are encouraged to email results to patients so they can bring them to all hospital appointments.
Case Study: Young Parents Clinic
Katrina is a 22-year-old woman who presented to her GP with an unplanned but welcome pregnancy at 5 weeks gestation Her GP organised appropriate booking investigations and referred her to RPA for antenatal care. Katrina attended her booking visit with the midwives at 17 weeks. She was offered and accepted antenatal care through the Young Parents Clinic.
First Trimester Screen available at RPA Fetal Medicine Unit
GPs can refer women to receive the combined First Trimester Screen (nuchal translucency/fetal anatomy ultrasound and pre-eclampsia screen at 11+0-13+6 weeks gestation) at the RPA Fetal Medicine Unit. This service is bulk-billed for patients with Medicare. Pre-eclampsia screening alone is available for women who do not want aneuploidy screening. Women who screen as high risk for early onset pre-eclampsia (>1 in 100) are advised to start low dose aspirin. Referral information is available on the Preconception and Pregnancy Assessment Services HealthPathway.
Please note that the NIPT is not a replacement for the First Trimester Screen. Women are advised to attend a First Trimester Screen even if they have already returned a low risk NIPT result. Please see the Screening for Fetal Chromosomal Conditions HealthPathway for further information.
Dr Ritu Mogra and Dr Jose Flores from the RPA Fetal Medicine Unit recently provided an ANSC Obstetrics Update on First Trimester Screening and non-invasive prenatal testing (NIPT). A recording of this session is available on the CESPHN YouTube channel.
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