ANSC June 2021 Update: Royal Hospital for Women

Contact details for RHW

For clinical or general ANSC advice, please contact ANSC Liaison Midwife Chantelle du Boisee:

Monday and Thursday 8.00am-5.30pm (Please note these days have changed)

Phone – 9382 6016

Mobile – 0417 995 153 (Monday – Friday 8.00 – 4.30)

Mobile phone will be answered by senior midwife on remaining weekdays

Email – Chantelle.duBoisee@health.nsw.gov.au

If you need to speak directly to the Obstetric Doctors please call ph.9382 6111 and ask the switch to page the on-call Obstetric Registrar.

For more urgent 24hr advice, contact Delivery Suite ph. 0439 869 035 (from 20 weeks pregnancy).

Change in Obstetricians at RHW: Dr Alex Owen

There has been a change in the ANSC Obstetricians at RHW. Dr Stephen Horrowitz has moved into the role of Director of Gynaecology and Dr Alex Owen has replaced Dr Horrowitz.

Dr Alex Owens Bio:

I am an obstetrician, gynaecologist and ultrasound specialist. I hold a Fellowship of RANZCOG as well as a Diploma of Diagnostic Ultrasound.  I take a collaborative approach to managing pregnancy: my role is to provide professional advice and balanced information, based on the latest scientific literature, to help women make decisions that they feel comfortable with.

The Antenatal Shared Care Obstetric clinic is held in the mornings from Monday – Thursday:

• Monday – Dr Alex Owen
• Tuesday – Dr Louise Fay
• Wednesday – Dr Stephen Coogan
• Thursday – Dr Siobhan Lee

Intake session

RHW will be running a face-to-face Intake session on the 13 November 2021 for all new GPs requesting to join the ANSC program and for GPs requesting cross affiliation ANSC. 

To register interest please contact Kylie Sommerville from CESPHN at k.sommerville@CESPHN.com.au

Preterm birth prevention clinic

RHW has recently commenced a weekly preterm birth prevention clinic under the care of Dr Daniel Challis and Dr Laura Gerhard (MFM Fellow). Please see the   attached information (138 KB)  on the clinic.

COVID-19 updates

The antenatal visit schedule is still revised in response to COVID-19. Please review the following documents as guidance for antenatal care with RHW Royal Hospital during this time.

RHW visitor policy has changed as follows:

• 2 visitors per woman at a time
• Only 2 parents/carers to visit babies in Newborn Care
• Children – only siblings of a new baby are permitted to visit
• Further visitors for compassionate reasons at the manager’s discretion

Obstetric and Neonatal Clinical Placements are still not being held due to ongoing COVID-19 restrictions and this will be reviewed in 2 months.

Royal Applause

This is a new column where RHW provides recognition of the excellent work performed by ANSC GPs. This month we have a great example and recognise the work of Dr Alana Lessi from Bondi Doctors, who pursued thorough follow up care for one of her patients who had postpartum bladder issues.

Ask the Royal

This a new column written by Obstetricians and other Medical Specialists, drawn from regular questions asked by GPs via the GPSC advice line.

This month Dr Akshara Shyamsunder, O&G Registrar at RHW has written a    pdfPreterm Birth Synopsis (134 KB) .

Gestational Diabetes Mellitus (GDM) Update

Please be mindful that some pathology labs use different reference ranges for diagnosing GDM. The RHW criteria for diagnosing GDM is as follows:

FASTING >5.1 mmol/L

1 HOUR >10 mmol/L

2 HOUR >8.5 mmol/L

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 SESLHD-RoyalHospitalforWomen-DiabetesServices@Health.nsw.gov.au

Please address the referral to Prof. S Lowe/Dr S M Lau/Dr A Beech/Dr T Young and attach the pathology results. You can also fax the referral and results to 9382 6118.

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 Obstetrician/and or Medical Physician review, please fax the referral to 9382 6118.

 Please note these Important changes with the booking process during COVID-19:

• Booking visits are via telehealth video appointment.
• A woman who requires an Interpreter or has complex psychosocial issues will now need to attend the hospital in person for the booking 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 SESLHD-RHWOPDRESULTS@health.nsw.gov.au (please send as one document)

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.

Medical Disorders in Pregnancy Clinic

Referrals to medical physicians at the Medical Disorders in Pregnancy Clinic must be addressed to Professor Sandra Lowe/Dr Amanda Beech. The patient will be contacted directly to arrange an appointment only after the referral has been received. Please fax referrals to 9382 6118.
The clinic is open on Thursday afternoons.  

Accessing Local Operating Procedures

You can access useful clinical policies, procedures and guidelines at RHW here.

Newly reviewed local operating procedures for Antenatal Care include:

• Hepatitis C positive mothers and their babies (Alphabet H)
• Thrombocytopenia in Pregnancy (Alphabet T)
• Twin Pregnancy – antenatal care (Alphabet T)

Important and helpful policy reminder:

• Thyroid disease in pregnancy: management of women with subclinical or overt thyroid disease in pregnancy

Reminder: 20 week GP visit

Click here for a reminder of essential information for the 20 week’s visit.

The IRONWOMAN study at RHW

The IRONWOMAN study has started at the Royal Hospital for Women. This is a study for the treatment for iron deficiency anaemia in pregnancy. The study is being undertaken at the Royal Hospital for Women and St George Hospital. Please read the  attached document (165 KB)  for further information about the study.

If you have any patients who may be eligible and or interested, please contact the research midwife on 0429 557 084 or 0407 498 197 (Monday-Friday 9am-5pm ). Please contact the investigators if you have any questions about the study on Antonia.shand@sydney.edu.au.

Genetic counselling

Please ensure that you are familiar with the RHW Genetic Counselling policy. A flowchart at the end of the Genetic Counselling Policy is helpful with navigating the correct referral pathway.

Important reminder: Women referred for a NIPT (from 10 weeks gestation) must also be referred for a Structural NT Ultrasound at 12-14 weeks gestation.

 Any woman who receives an increased risk aneuploidy screening result (cFTS or NIPT) or has a structural anomaly detected on ultrasound can be referred to the Maternal Fetal Medicine Department at RHW. They will be offered genetic counselling, a repeat ultrasound, a consultation with a maternal fetal medicine specialist and prenatal diagnostic testing (such as amniocentesis or chorionic villus sampling), if appropriate. All these consultations will be covered by Medicare.

For GPs to arrange or discuss a referral please call the  ‘Fetus Phone’  on 0437 537 448  (Mon-Fri 9am- 4pm). For patient enquiries the number is ph. 9382 6098