Gynaecology

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Ectopic pregnancy
    • Ruptured haemorrhagic ovarian cyst
    • Ovarian torsion
    • Acute/severe pelvic pain
    • Significant or uncontrolled vaginal bleeding
    • Severe infection
    • Abscess intra pelvis or PID
    • Bartholin's abscess / acute painful enlargement of a Bartholin's gland/cyst
    • Acute trauma including vulva/vaginal lacerations, haematoma and/or penetrating injuries
    • Post-operative complications within 6 weeks including wound infection, wound breakdown, vaginal bleeding/discharge, retained products of conception post-op, abdominal pain
    • Urinary retention
    • Acute urinary obstruction
    • Any molar pregnancy
    • Inevitable and / or incomplete miscarriage
    • Hyperemesis gravidarum
    • Ascites, secondary to known underlying gynaecological oncology

    Termination of pregnancy

    • Consider providing advice that in an emergency situation, medical and clinical staff cannot conscientiously object to providing care following a failed early medical termination. All Hospital and Health Services will provide services to women who present for emergency care.

  • Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the CPC out of scope section.

  • The following are not routinely provided in a public Gynaecology service.

    • Elective cosmetic surgery e.g. labiaplasty

    NB labial hypertrophy in paediatric and adolescent patients: refer to Statewide Paediatric and Adolescent Gynaecology Services (SPAG) at Queensland Children's Hospital/RBWH.

    • Elective tubal ligation but will be accepted as a category 3, if :
      • patient cannot use/trialled other contraceptive methods
      • patient does not want to pass on any genetic disorders or disabilities
      • indicated for women suffering from medical or obstetric conditions that would contraindicate future pregnancy
      • within the scope of the health service
    • Routine contraceptive counselling
    • Routine Implanon/Mirena®/progesterone-releasing IUD insertion for contraception
      • unless within the scope of the local health service
    • Primary menopausal care
    • Cervical screening test
    • Postnatal check-up
    • Reversal of tubal ligation
    • IVF services
    • Elective termination of pregnancy*
    • Gender reassignment (Referral to Gender Clinic only) **

      *Termination of Pregnancy services are offered within scope of the Health service – refer to local pathways.
      Information for health practitioners can be found on the Clinical Excellence website (https://clinicalexcellence.qld.gov.au/priority-areas/service-improvement/termination-pregnancy) or by contacting 13HEALTH.

      **The Gender Service is located at the Royal Brisbane and Women’s Hospital and includes the following services:

    • Assessment and affirmative treatment of adults with Gender Dysphoria or gender non-conforming behaviour or identity.
    • Time-limited support from the Department of Social Work and Psychology for patients with social adjustments related to Gender Dysphoria.
    • Adjustment support for family and significant others
    • Therapeutic assessment and affirmative treatment of gender issues and other co-existing conditions
    • Speech Pathology service provides voice feminisation and masculinisation services to adults who have been seen by the RBWH Gender Service and meet criteria for gender incongruence/ dysphoria. Trans and gender-diverse patients cannot be referred directly to the Speech Pathology service.
    • Assessment and report by Psychiatrist for gender affirmation surgery
    • Assessment for co-existing developmental disorders (Autism, ADHD) or mental illness for adults who are already accessing the service for gender affirmation, if applicable.
    • Community linking and referrals to relevant services.
    • Medical assessment and commencement of gender affirming hormone therapy by the Sexual Health Physician once readiness for treatment has been confirmed.
    • Assessment of readiness for gender affirming hormone therapy and review following commencement of hormone therapy, as needed, by the GP with Special Interests (GPwSI).

Last updated: 20 August 2020

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