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Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Antenatal care requiring review within 30 days
  • Category 2
    (appointment within 90 calendar days)
    • Antenatal care requiring review within 90 days
  • Category 3
    (appointment within 365 calendar days)
    • No category 3 [6] criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention not otherwise accessible to the patient
  • For advice regarding management
  • To engage in an ongoing shared care approach between primary and secondary care
  • Reassurance for GP/second opinion
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)

2. Essential referral information Referral will be returned without this

  • Current pregnancy (*ensure early referral if risk factors identified, all referrals preferred by twelve weeks where possible)
    • Gravidity, Parity
    • LNMP (Last normal menstrual period),
    • EDB (Estimated Date of Birth)
    • Single or multiple pregnancy
    • Confirmation of pregnancy (positive urine or serum B-HCG)
    • BMI
    • BP
  • Past Obstetric history (if known) - for each previous pregnancy please provide details of outcome:
    • Date of birth, gestation, mode of birth, birth weight, place of birth
    • Any pregnancy complications e.g. GDM (Gestational Diabetes Mellitus), fetal growth restriction, pre-eclampsia, APH (antepartum haemorrhage)
    • Any birth complications e.g. PPH (Postpartum Haemorrhage), preterm birth, stillbirth, pre-existing birth trauma
    • Previous neonatal admission to SCN/NICU and reason
    • Miscarriage
    • Ectopic pregnancy
    • Termination of pregnancy
  • Summary of relevant medical, surgical, and psychosocial history including details of any risk factors/co-morbidities (e.g. diabetes, obesity, bariatric surgery, asthma, cardiac, renal or liver disease, hypertension, anaemia, eating disorders, mental health concerns etc)
  • Current medications including psychotropic drugs such as Sodium Valproate, Lithium and other medication with recognised fetal implications
  • Indigenous status, Ethnicity and language spoken (identify if interpreter is required)
  • Drug, alcohol, and smoking history
  • Routine antenatal bloods: FBC, blood group and antibody screen, rubella antibody screen, hepatitis B serology, hepatitis C serology, HIV serology, syphilis serology, Mid-Stream Urine for MCS

3. Additional referral information Useful for processing the referral

  • Method of conception (either spontaneous or assisted)
  • First trimester early OGTT (preferred) or HbA1c – if risk factors for gestational diabetes
    • BMI > 30 kg/m2 (pre-pregnancy or on entry to care)
    • Ethnicity (Asian, Indian subcontinent, Aboriginal, Torres Strait Islander, Pacific Islander, Maori, Middle Eastern, non-white African)
    • Previous GDM
    • Previous elevated Blood Glucose Level (BGL)
    • Maternal age ≥ 40y
    • 1st degree relative with DM or sister with GDM
    • Previous macrosomia (birth weight > 4500 g or > 90th percentile)
    • Previous perinatal loss
    • Polycystic Ovarian Syndrome
    • Medications (corticosteroids, antipsychotics)
    • Multiple pregnancy
  • Advise if new partner with this pregnancy
  • Prenatal screening and diagnostic testing for fetal chromosome and genetic conditions e.g. combined first trimester screen, NIPT, CVS, amniocentesis, genetic carrier screening
  • Ferritin
  • TSH – if > 30y or other thyroid risk factors (family history, autoimmune disease including coeliac disease, T1DM etc)
  • ELFT's and Urine protein/creatinine ratio if indicated e.g. women with BMI >30, pre-existing hypertension, diabetes
  • Chlamydia investigation for women ≤30y or if risk factors
  • STI screen result as indicated
  • Cervical screening reports if >25y or indicated
  • Include pathology relevant to any medical history i.e. known cardiac renal or liver disease
  • Dating, Nuchal Translucency and Morphology Ultrasound scans
  • Immunisation information (e.g. Influenza, COVID vaccination status, has Pertussis been discussed and planned for after 20 weeks?)
  • Include imaging relevant to any medical history i.e. known cardiac, renal or liver disease

Other considerations

  • Refugee status
  • Social history including domestic violence, living situation, drug and alcohol use
  • Identification of Gillick competence and intellectual capacity (where appropriate)
  • Recognition of sexual orientation i.e. Lesbian, Gay, and Bisexual (LGB)
  • Woman's preferred model of care
    • GP shared care (is the GP aligned?)
    • Midwifery care
      • Birth centre
      • Midwifery Group Practice (MGP)
      • Other
    • Obstetric care

4. Request

Last updated: 21 June 2023