ANSC DecEMBER 2024 update: RPA Women and Babies/Canterbury Hospital

Fundal height charts are coming

The Clinical Excellence Commission (CEC) has introduced some new screening tools to improve detection of Fetal Growth Restriction (FGR) during pregnancy.  FGR is associated with adverse perinatal outcomes including stillbirth.

Among the new screening tools are the statewide introduction of:

• the NSW Fetal Safety Risk Assessment Pathway and;
• the NSW Health International Symphysis-Fundal Height Standards chart

Serial plotting of fundal height on the new chart is to be conducted as part of routine antenatal care, at every GP and hospital visit, starting from 24 to 28 weeks gestation.

You will soon see the fundal height chart stapled to the back of yellow cards.

Please measure fundal height using the standardised technique and plot the measurement on the chart at every antenatal visit from 24 weeks.

Women who are unsuitable for fundal height measurements (eg BMI >40 or large uterine fibroids >10cm), or who have identified risk factors for FGR, will require regular fetal growth and wellbeing ultrasounds.

Further information and clinician resources can be found on the CEC Fetal Growth Restriction website and guideline Care of women with suspected or confirmed Fetal Growth Restriction.

Case Study – An update on options and how to safely prescribe oral postnatal contraception

Oral Postnatal Contraception

RPA/Canterbury ANSC: Educational Case Study Series – December 2024 

How to contact the hospital for clinical advice

Do you need to contact the hospital for clinical advice regarding an ANSC patient? For non-urgent clinical advice Monday-Friday 8:00am-4:30pm, please call GP Liaison Midwife Melanie Tulloch on 0425 230 662.

If you are unable to reach the midwife liaison phone and need urgent advice, please refer to the Urgent Antenatal Assessment Health Pathway, which contains details including how to page the obstetric registrar through the hospital switchboard.

You can also find other relevant referral pathways (including EPAS, Ultrasound and Perinatal Mental Health Assessment) on the Pregnancy Requests page of Health Pathways.

RPA Virtual Hospital Hyperemesis Gravidarum Care

The RPA Virtual Midwifery offers personalised support and management for women with moderate to severe nausea and vomiting during pregnancy, reducing emergency department visits. Early referral to this service allows timely management to improve symptoms and quality of life.

In collaboration with Hospital in the Home (HITH) staff, women receive specialised care, including medication management, IV fluids, and access to dietetics, social work, and psychologists. Midwives provide virtual care through telehealth, follow-up calls, and digital surveys via the Go Share platform.

GPs are encouraged to refer eligible women to the RPA Virtual Midwifery Service via Health Pathways. Exclusions apply for those outside the Sydney Local Health District or not planning to birth at an SLHD facility. Click here for more information, or call RPA Virtual Midwives at 1800 325 065, option 3.

No geographical restrictions on maternity referrals to RPAH and Canterbury Hospital

There are no postcode boundary restrictions on antenatal referrals to RPAH and Canterbury Hospital.

Women residing within the Sydney Local Health District postcode catchment area are encouraged to book at their local hospital, to receive care close to home and access to the full range of antenatal care options available. However, referrals from outside SLHD are also welcomed at RPAH and Canterbury.

Please note that eligibility for programs that involve home visits (eg MGP, MAPS, Midwifery at Home postnatal visits) are restricted to those who reside within the hospital’s postcode boundaries.

RSV vaccine rollout in 2025

From early 2025, pregnant women will be offered a free vaccine against respiratory syncytial virus (RSV) under the National Immunisation Program. The vaccine will be recommended to women at 28-36 weeks and will in turn protect their newborn infant from RSV.

Babies with certain risk factors have been eligible for the nirsevimab vaccine since September this year, as part of the NSW RSV Vulnerable Babies Program. From 2025, the government will fund free vaccination for all babies who are not protected through maternal vaccination, and those at increased risk of severe RSV.

Detailed information about the program, including FAQs for health professionals, is available on the NSW Health website. Updates will be included in future newsletters as further details of the program rollout become available.

Sydney HealthPathways

The HealthPathways Sydney team have published several updated pathways including:

• Hypertensive Disorders in Pregnancy and Postpartum (HDP)
• Perinatal Mental Health Assessment
• Maternal postnatal check
• Antenatal First Consult

The team are also excited to introduce personal HealthPathways accounts, designed to enhance your experience and provide you with exclusive features.

Starting from 2nd December 2024, you can register for your own HealthPathways account and unlock a more personalised, convenient, and streamlined experience. For more information, click here.

Electronic Referrals to Sydney LHD Women’s Health Services

Electronic referrals via HealthLink Smartforms are the preferred method of referral to SLHD Women’s Health services listed below:

• RPAH, Canterbury and Concord Maternity
• RPAH Fertility
• RPAH Gynaecology
• RPAH Early Pregnancy Assessment Service (EPAS)
• RPAH Fetal Medicine Unit

Referral forms to these services are hosted within the Sydney LHD Women’s Health and RPAH Gastroenterology Services folder on the HealthLink landing page.

GP referrals sent via other methods (fax, email, walk-in) will start to be phased out over the coming months.

Please note: Scan requests for Non-Invasive Prenatal Testing and Combined First Screening can continue being made for women birthing at RPA Hospital via the RPAH Antenatal eReferral form when referring women for their first antenatal consult.

HealthLink Update eReferral feature: Adding additional information to existing referrals

The HealthLink Update Referral feature allows GPs to review and submit additional information to active referrals if the patient’s condition has changed or in response to a request for further information from the service or clinic.

The Update Referral feature in your HealthLink platform also enables you to see key information for each referral including:

• Referral Status
• Priority assigned by the triaging team
• Notes added by the triaging team

For more information on how to submit and update eReferrals, please refer to the HealthLink Smartform user guides.

If you require any support with eReferrals to SLHD, please contact the eReferral Project Team – SLHD-EReferralProject@health.nsw.gov.au or 0477 501 385