ANSC MARCH 2025 update: RPA Women and Babies/Canterbury Hospital

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.

Please note: Requests for Non-Invasive Prenatal Testing and Combined First Screening can be made for women birthing at RPA Hospital via the RPAH Maternity eReferral form when referring women for their first antenatal consult. GPs are not required to send a separate Fetal Medicine Unit referral for these women if they have requested these scans on the maternity eReferral form.

GPs are requested to refer to a named specialist from the Referred To drop down box, regardless of preferred model of care.

Update eReferral feature: Adding additional information to existing referrals

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

The Update Referral feature in the 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

RPA Hospital Fetal Medicine Unit: HealthLink eReferrals

HealthLink eReferrals are the preferred method of referral to RPAH Hospital Fetal Medicine Unit. GPs are encouraged to no longer use the paper-based tear off pads or PDF forms to refer women to this service.

The eReferral form can be found on the new Sydney LHD Women’s Health and RPAH Gastroenterology Services link on the HealthLink landing page.

The RPAH Women’s Ultrasound and Fetal Medicine eReferral form can be used to request pregnancy ultrasounds and gynaecological ultrasounds and procedures. A full list of available services is available on the eReferral form and on HealthPathways Sydney.

GPs are reminded that Combined First Trimester Screening and NIPT can also be arranged when making an antenatal electronic referral to Royal Prince Alfred Hospital.

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

Monthly online drop-in session with Clinical Midwife Consultants

First Thursday of every month 12:30-1:30pm

*Beginning Thursday 6^th March

Click here to drop in GP ANSC RPA/Canterbury Drop-In Session with CMC

There will be a monthly online drop-in session held on the first Thursday of each month with Clinical Midwife Consultants from RPA and Canterbury Hospitals. All GPs are welcome to attend, regardless of whether they are part of the SLHD Antenatal Shared Care program.

This is not a formal education session, but rather an opportunity for GPs to drop in at any time during the hour to discuss any issues or questions they may have. The midwives are available to discuss any topics related to maternity care, including:

• Referrals
• Antenatal care options
• Early pregnancy care
• Genetic carrier screening and first trimester screening/NIPT
• Obtaining results or reports from the hospital
  

GPs are also welcome to call the ANSC/GP Liaison CMC, Melanie Tulloch, at any time from Monday to Friday 8am-4:30pm on 0425 230 662. The Genomics CMC, Elizabeth Austen, is also available Monday-Friday on 0448 333 516 to answer questions about early pregnancy screening. Please leave a voice message if they are unavailable, as calls are usually returned within a few hours.

RSV vaccine rollout in 2025

Pregnant women are now eligible for a free vaccine against respiratory syncytial virus (RSV) under the National Immunisation Program. The Abrysvo vaccine is recommended to women at 28-36 weeks and will in turn protect their newborn infant from RSV.

If you are administering the Abrysvo vaccine during pregnancy, please note this on the yellow card including date, gestation and batch number.

Babies born to mothers who were either not vaccinated during pregnancy, or vaccinated less than 2 weeks before birth, will be eligible for a free ‘catch up’ Beyfortus (Nirsevimab) RSV vaccine. To assist GPs in determining which babies are eligible for a free ‘catch up’ vaccine, SLHD is in the process of updating maternal and neonatal discharge summaries to automatically include maternal vaccination status.

The RPA Newborn Care team will offer the vaccine to babies included in the NSW RSV Vulnerable Babies Program (e.g. those born prior to 32 weeks gestation) when they attend the hospital for ongoing outpatient visits.

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.

Eligibility criteria for MGP and MAPS

When discussing antenatal care options with your patients in early pregnancy, please be aware that Midwifery Group Practice (MGP), Midwifery Antenatal and Postnatal Service (MAPS) and Birth Centre operate as low to moderate risk at entry services.

Suitability is assessed on a case-by-case basis. Generally, pregnancies with Category A and B risk factors, as outlined in the National Midwifery Guidelines for Consultation and Referral, are eligible for MGP, MAPS and Birth Centre.

Examples of more significant risk factors that make MGP, MAPS and Birth Centre unsuitable include: 

1. Twin pregnancy
2. SLE
3. Pre-existing diabetes
   

Examples of risk factors that usually do not affect eligibility for MGP, MAPS and Birth Centre include:

1. Well-controlled hypothyroidism
2. Maternal age >40
3. IVF pregnancy
4. On low dose aspirin due to screening as high risk for pre-eclampsia on combined First Trimester Screen (cFTS)
5. Wanting VBAC
6. Previous perinatal loss
   

Early discharge (approx. 4-6 hours after birth) is encouraged for women receiving care through MGP, MAPS and Birth Centre who have a medically uncomplicated birth, with no clinical indication to remain in hospital. They will then be visited at home by a midwife soon after discharge. Please discuss this expectation with patients choosing these models of care.

A note on postcode boundaries:

Please note that only pregnant people residing within the hospital’s catchment area are eligible for MGP, MAPS and Birth Centre, as these programs involve home visits. Pregnant people who live outside the catchment area are still welcome to book at the hospital of their choosing, however they will be directed to either GP Antenatal Shared Care or standard antenatal care and will not be eligible for postnatal home visits.

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.

Split (2 x 45-minute) antenatal booking visits have begun at RPA

RPA is in the process of restructuring antenatal care so that all people birthing at RPA are offered a Combined First Trimester Screen (cFTS) and midwife booking on the same day, up to 13+6 weeks gestation. This is part of the RPA Antenatal Clinic Redesign (ANTICIPATE) project.

Women who receive a booking in the Antenatal Clinic are now being offered a 45-minute midwife booking visit, ideally on the same day as their cFTS, followed by a second 45-minute booking visit a few weeks later. The second visit includes a psychosocial screen and completion of the Edinburgh Depression Scale (EDS).

At present, women who book with MGP, MAPS or Birth Centre, or who are more than 20 weeks pregnant, continue to receive a standard 90-minute booking visit.

Case Study

RPA/Canterbury ANSC: Educational Case Study Series – Click here

Opening maternity wing at RPAH

RPA opens new private Maternity wing:

(Image from left to right: Head Obstetrics Dr Stephen Morris, MUM Tarryn O’Loughlin, General Manager Kiel Harvey)