ANSC July 2023 update: RPA Women and Babies/Canterbury Hospital

RPA/Canterbury:

Canterbury Hospital and Concord Midwifery Group Practice now accepting electronic-referrals

Referrals to Canterbury and Concord Hospital maternity services are now using the HealthLink electronic referral system. For GP practices without a compatible practice software system referrals can be made through the MyHealthLink Portal or by fax, using the SLHD Fax coversheet including the Canterbury Maternity Health and Pregnancy History Form.

SmartForm details and fax numbers are detailed in the table below:

SLHD maternity services continues to appreciate your use of eReferrals as the preferred method of referral. Please ensure you attach all relevant antenatal investigations to ensure accurate triage. Referring at approximately 8-10 weeks is important because it allows for booking in visits at 14-16 weeks.

Should you need assistance with any e-referral enquiries, please reach out to SLHD-EReferralProject@health.nsw.gov.au for support.

Enquiries to childbirth, parenting and breastfeeding classes remain via phone as detailed below:

Updated Ultrasound and Fetal Medicine Referral Form (RPA Women and Babies)

An updated Fetal Medicine Referral Form can be accessed here – Fetal Medicine Ultrasound Request.[AW1] 

ANSC Case study series

Click here for the full case study

Carbon Monoxide (CO) Monitoring

The Smokerlyzer is a CO monitoring tool that NSW health recommends for use in pregnancy. It provides visual feedback with a number or traffic light system that can be used to motivate smoking/vaping cessation. SLHD commenced CO monitoring on the 26 June. This will be offered to all women/pregnant people at their booking in visit and at 28 weeks. Those who currently smoke/vape or have ceased within the last year will be offered the Smokerlyzer at each antenatal visit. ANSC providers can purchase a Smokerlyzer for your practice at www.bedfont.com. It is intended for multi-patient use and requires the purchase of single sterile exhalation tubes, and replacement d-pieces. 

Cervical Screening Test (CST)

Reminder that offering and attending CST is recommended and safe in pregnancy. RPA and The Canterbury Hospital encourages ANSC providers to ensure that all women/pregnant people are offered a cervical screen if it has been greater than 5 years or if they have been recommended a repeat sooner following an abnormal result.

Influenza Vaccine

RPA and Canterbury Hospital are not stocking and administering influenza vaccines this flu season. Please ensure that you offer all women/pregnant people their influenza vaccine opportunistically at any stage of their pregnancy. If the woman/pregnant person has been vaccinated pre-pregnancy, please offer the vaccination late in the third trimester.

Preterm Birth Clinic

RPA has a Preterm Birth Clinic each Friday. Please refer all women/pregnant people at ten weeks with:

• a history of birth <37 weeks
• a history of a shortened cervix (<25mm) with previous pregnancies, or detected on transvaginal ultrasound at their fetal morphology ultrasound.
• history of cervical cerclage in previous pregnancies.

Please eRefer into the general Obstetrics clinic and make note of the history to ensure accurate triage. You can call the ANSC CMC Chauncey Sjostedt on 0425 230 662 to discuss during business hours.

Reduced / Static Fundal Height

This is when there has been a fundal height measurement that is incorrect for dates +/- 3cms, or remains static in the absence of descent of the presenting part into the pelvis. In this instance, it is imperative that the woman/pregnant person is referred for a growth and wellbeing ultrasound, and to the hospital for a consultation following ultrasound.

Low Dose Aspirin (LDA)

In addition to LDA being a beneficial tool to prevent rates of pre-eclampsia, it also has demonstrated benefits in the reduction of fetal growth restriction. This flowchart outlines the current process of risk assessment and management.  The optimal window to commence 150mgs/day of LDA is 12-16 weeks. Please refer to HealthPathways for further information.

Every Week Counts

RPA is participating in a national collaborative called Every Week Counts to reduce the rate of preterm birth by 20% by 2024. SLHD is requesting your assistance with:

• explaining to women/pregnant people that they may require a transvaginal ultrasound at their fetal morphology ultrasound if their cervical length is less than 35mm when scanned transabdominally.
• referring women/pregnant people into the preterm birth clinic if they have a cervix of 25mm or less at fetal morphology USS.
• speaking to women/pregnant people about the benefits of not inducing labour or having a planned CS earlier than 39 weeks.

These are some useful resources to guide your discussions.  Please see the Every Week Counts newsletter for more information.

Models of Care

Please refer to linked information sheet about available models of care at RPA and Canterbury Hospital. We acknowledge that it can be confusing to know where to refer women, and this cheat sheet is a useful tool to clarify.

Combined First Trimester Screening (cFTS) and NIPT at RPA Fetal Medicine Unit (FMU)

FMU has dedicated cFTS and NIPT appointments available for women/pregnant people birthing at RPA. Please email the referral slip to: rpafmu@health.nsw.gov.au. The cFTS includes structural ultrasound, nuchal translucency assessment and pre-eclampsia screening. This important screening test for pre-eclampsia is not routinely done at every ultrasound provider, and this service is offered free at RPA. We recommend all women/pregnant people consenting to early pregnancy screening have a cFTS. The NIPT is an additional test and costs $350.

Baby Buddy

Baby Buddy is an award-winning pregnancy and parenting app. It was developed in the UK and adapted for Australia by the University of Sydney in collaboration with parents and health professionals, with funding from the Department of Health.  Baby Buddy provides validated, evidence-based information that is supported by over 400 videos in easy-to-read English.  The app can be personalised by the user and is interactive. It covers topics from healthy eating, safe exercise during pregnancy, mental health, relationships, labour and birth, stillbirth awareness and risk reduction, newborn care and infant feeding.  We are piloting the app within the Sydney Local Health District and in Western NSW Local Health District. It is available nationally through the AppStore and on Google Play.  Contact Karin Birkner (Karin.birkner@health.nsw.gov.au or 0414247216) for more information.

Parenting Classes

The Sydney Local Health District Parent Education service invites all families to join our Early Pregnancy Information session. The Early Pregnancy Information session is FREE, conveniently presented on ZOOM about every 2 weeks. We provide mums, dads, parents, and support people with reliable information about maternity, and child and family health services available across the district. We discuss current recommendations about pregnancy health, what to expect in the first few weeks and months and share resources. Facilitated by an experienced midwife and child and family health nurse, there are opportunities to ask questions, supporting families to make informed decisions when pregnant or planning a future pregnancy.

To book: https://www.slhd.nsw.gov.au/RPA/WomenAndBabies/parentEducation/form.html