ANSC update October 2023 RHW:

Contact details for RHW

Email address for GP enquiries at RHW: SESLHD-RHWGPSCEnquiries@health.nsw.gov.au

Antenatal Shared Care (ANSC) GP Liaison Midwife Chantelle du Boisee workdays are Monday and Tuesday 8.00am-6.00pm. (Please note these days have changed). Email – Chantelle.duBoisee@health.nsw.gov.au

For Clinical GP Advice line call 0417 995 153 (Monday – Friday 8.00-4.30). The mobile phone will be answered by the liaison midwife or the senior in charge midwife.

If you need to speak directly to the Obstetric doctors, please call 9382 6111 and ask the operator to page the on-call Obstetric Registrar for ANSC.

The Obstetric Medicine Physician Registrar can be contacted for advice Monday-Friday during business hours by calling 9382 6111. Advise the operator to page the Registrar.

For more urgent 7 day /24hr advice, contact Delivery Suite on 0439 869 035 or 9382 6100 (from 20 weeks pregnancy).

National Preterm Birth Prevention Collaborative

RHW has joined the National Preterm Birth Prevention Collaborative with the aim to reduce the rate of preterm birth and early term birth in Australia by 20 percent. Please help RHW to reduce the rate by following the Referral Guidelines for Preterm Birth Prevention Clinic.

Dr Antonia Shand is the lead collaborative consultant. Dr Sarah Lyons leads the Monday morning clinic located in maternity OPD.

Brochures for parents and health care professionals about the importance of the last few weeks of pregnancy for babies’ health and development can be found here.

Vicky Gay, the Preterm Birth Prevention Clinic Midwife can be contacted on 0487 072 925 or at Victoria.Gay@health.nsw.gov.au for further information and referrals to the clinic.

Please see this letter to GPs from Dr Antonia Shand and Dr Sarah Lyons regarding some important updates on the National Preterm Birth Prevention Collaborative.

Boostrix and flu vaccine

A reminder that the Boostrix vaccine is recommended to be given by the GP between 20 – 32 weeks of pregnancy as stated in the RHW ANSC Protocol Summary. The Flu vaccine can be given at any time during the pregnancy.

Early Pregnancy Assessment Centre (EPAS) AT RHW

To refer to EPAS please fax a referral to 9382 6638. Follow up the fax with a phone call to 9382 6701 to arrange an appointment, which will usually be made for the next weekday. Prior to the appointment the clinic will need all ultrasounds, a Beta hCG and a blood group and antibody screen. For further information on EPAS refer to the clinical business rule.

Infectious syphilis

Infectious syphilis is increasing in the general population and has led to an increase in congenital syphilis cases in NSW.  NSW Health now recommends all pregnant women be screened for syphilis at least twice in the pregnancy, at the first antenatal visit and again at 26-28 weeks’ gestation. See the Safety notification from NSW Health on this matter. 

Reminder for 20-week GP visit

Please give blood request referrals for 26–28-week bloods at the 20-week visit. See reminder of activities and considerations at the 20-week GP visit.

Pregnancy ultrasounds

Please refer to Specialised Obstetric Ultrasound Practices on 9382 6080 for all pregnancy ultrasounds. RHW ultrasound department accepts referrals for third trimester ultrasounds.

GP antenatal visits

If a woman’s GP is not available for a routine GP antenatal visit, please ensure the woman sees another RHW ANSC accredited GP at the practice. If an accredited GP is not available, call the GP Liaison Midwife to organise a hospital appointment on 0417 995 153.

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. The woman will receive a call from a private number to arrange the first booking appointment within 2-3 weeks of applying. Women can follow up this appointment by calling 9382 6048.

If your patient needs a more urgent Obstetric/and or Obstetric Medicine Physician review, please fax the referral to 9382 6118.

From the 1st of June 2023 all hospital booking in visits have returned to face-to-face appointments.

• The GP is NOT required to complete the yellow card as this will continue to be completed by the booking in midwife.
• The GP needs to complete the entire RHW antenatal referral form. Please give the referral, antenatal pathology, ultrasound results and any other relevant documentation to the woman to bring to the first booking appointment. It is no longer necessary to fax or email the results.

NB: Please ensure that All RESULTS for the entire pregnancy are given to the woman to bring to their next hospital visit. Please do not fax, mail, or CC in any results unless you have urgent clinical concerns.

The fillable form version of the Antenatal Referral form is now available here.

Ask the Royal

The information contained in this column is written by Obstetricians, Medical Specialists, and other Health Clinicians and is drawn from regular questions asked by GPs via the ANSC advice line.

Dr Helen Barrett RHW Obstetric Medicine Physician and Endocrinologist has created a brief synopsis of common scenarios with Thyroid Disease in Pregnancy here.

Please also refer to the relevant clinical business rule.

Medical disorders in pregnancy clinic

Referrals to Obstetric Medicine Physicians at the Medical Disorders in Pregnancy Clinic must be addressed to Professor Sandra Lowe/Dr Amanda Beech/Dr Helen Barrett. The patient will be contacted directly to arrange an appointment only after the referral has been received. Please fax referrals to 9382 6118.

Hyperemesis Gravidarum (HG) Initiative

The new policy released from NSW Health on Nausea and Vomiting in Pregnancy can be found here.

Accessing Local Operating Procedures (LOP’s) now known as Clinical Business Rules (CBRs)

Updated CBRs:

Follow-up After Birth (FAB) Clinic – Postnatal Symptom Assessment

Breastfeeding – Protection, Promotion and Support

You can access Clinical Business Rules at RHW here.

Upcoming RHW CPD events

ANSC Update CPD event 11 November

Please join us for the ANSC Update for RHW on Saturday 11 November, 12pm-3:30pm. This will be a hybrid event, with topics including First baby over 45 years and Genetic testing. For further information and to register, click here.

ANSC RHW Obstetrics Clinical Placement – 25 October and 29 November

Obstetrics Clinical Placements are provided to GPs who are affiliated with The Royal Hospital for Women Antenatal Shared Care Program. This gives those GPs a chance to shadow an Obstetrics Specialist through the Antenatal Ward at RHW. Please note that to ensure minimal disruption to the ward and its patients only six places are available at each clinical placement and ward rounds begin at 5:30pm sharp. Register for the 25 October Clinical Placement here.

Register for the 29 November Clinical Placement here.

RHW ANSC Protocol Guidelines and Protocol Summary (Updated May 2023)

Protocol Guidelines

Protocol summary

Test your knowledge about iron in pregnancy and treatment with oral iron

The Royal Hospital for Women is completing a quality improvement project on pregnant women with iron deficiency anaemia and treatment with oral iron.

Two major gaps in care have been identified:

1. Inconsistent advice about oral iron treatments
2. Delayed completion of blood tests (Hb & Fe) to confirm a treatment response

RHW is targeting clinicians that care for pregnant women to ensure that women receive similar care and advice. Your participation in a quiz to test your current knowledge would be appreciated.

Please click here to complete the quiz.

Results will be provided in the next ANSC newsletter.