ANSC July 2022 Update: St George and Sutherland hospitals

Updated ANSC Protocol and Protocol Summary

The St George and Sutherland Hospitals antenatal Shared Care protocol and Protocol Summary have been updated.

The updated guidelines are available on the CESPHN website and South Eastern Sydney HealthPathways.

Please ensure you are referring to the most up to date versions by clearing your browser history.

Booking changes at Sutherland hospital

Sutherland Hospital now uses an online booking system for antenatal appointments and no longer takes phone bookings. Women can book via the Antenatal Appointment Form – Sutherland Hospital

Women can book an antenatal appointment at St George Hospital via the Antenatal Appointment Form – St George Hospital 

The hospital will contact the woman via email with a booking appointment.

Women that are out of area can send an email to the Manager of the hospital they wish to birth at asking to be accepted as an out of area booking.

Gestational diabetes mellitus flowcharts

The flowchart for screening, diagnosing and referring of Gestational Diabetes Mellitus has been updated to reflect that screening for high risk women should ideally be after 13 weeks gestation.

The National Gestational Diabetes Register follow-up flowchart by the National Diabetes Services Scheme (NDSS) describes the recommended follow-up for women after a pregnancy with gestational diabetes. General practitioners  and other health professionals can use this as a guide to routine diabetes checks, referral pathways and future pregnancy planning. 

Hyperemesis Gravidarum

Hyperemesis Gravidarum is the leading cause of hospitalisation during early pregnancy, and second to premature labour as the leading cause overall during pregnancy. HG usually extends beyond the first trimester and may resolve by 21 weeks; however, it can last the entire pregnancy.

Severe HG is often associated with:

• loss of greater than 5 percent of pre-pregnancy body weight (usually over 10 percent),
• dehydration,
• nutritional deficiencies,
• metabolic imbalances,
• severe fatigue and debility,
• depression/anxiety and trauma,
• premature labour/delivery, and
• adverse fetal complications.

Emerging evidence has found a genetic association predisposing women to HG and children born to mothers diagnosed with HG, are more predisposed to autism spectrum disorder, learning difficulty, depression, anxiety and processing disorders.

May is HG awareness month, NSW Health used the awareness day on Sunday 15 may to highlight awareness of HG on their Facebook page and launched a dedicated webpage to educate professionals and the public about HG.

The NSW Health Guideline Identification and Management of Nausea & Vomiting in Pregnancy and Hyperemesis Gravidarum is due to be published and will ensure clear management and treatment pathways. SESLHD aim to develop models of care that integrate hospital, community and primary care pathways to optimise treatment that suits the needs of the community and hospital service.

SESLHD project lead Joanna Pinder can be contacted with any questions regarding care of women with HG. Joanna Pinder can be contacted via email at joanna.pinder@health.nsw.gov.au

For further information see link to the NSW Health – Hyperemesis Gravidarum Fact Sheet.