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Antenatal and Maternity

Conditions

Emergency department referrals

All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:

  • Caboolture Hospital (07) 5433 8888
  • Redcliffe Hospital (07) 3883 7777
  • Royal Brisbane and Women's Hospital (07) 3646 8111

Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

  • Suspected or proven ectopic pregnancy
  • Heavy bleeding/severe pain (haemodynamically unstable) +/- fever (suspicion of sepsis)
  • Threatened or incomplete miscarriage if haemodynamically unstable
  • Intractable vomiting

  • Heavy bleeding/severe pain (haemodynamically unstable) +/- fever (suspicion of sepsis)
  • Threatened or incomplete miscarriage
  • Threatened preterm labour
  • Pre-term rupture of membranes
  • Evidence of cervical incompetence
  • Intractable vomiting
  • Hypertension equal to or greater than 140/90 mm Hg
  • Severe headaches or visual disturbances
  • Suspected pre-eclampsia presenting with hypertension systolic blood pressure equal to or greater than 140mmHg and/or diastolic blood pressure equal to or greater than 90 mmHg and one or more of the following organ/system features related to the mother and/or fetus:
    • Renal
      • Random urine protein to creatinine ratio greater than equal to 30mg/mmol from an uncontaminated specimen (proteinuria)
      • Serum or plasma creatinine greater than or equal to 90 micromol/L or
      • Oliguria (less than 80 mL/4hours or 500 mL/24 hours)
    • Haematological
      • Thrombocytopenia (platelets under 150 x 109/L)
      • Haemolysis (schistocytes or red call fragments on blood film, raised lactate dehydrogenase (LDH), decreased haptoglobin)
      • Disseminated intravascular coagulation (DIC)
    • Liver
      • New onset of raised transaminases (over 40 IU/L) with or without epigastric or right upper quadrant pain
    • Neurological
      • Headache
      • Persistent visual disturbances (photopsia, scotomata, cortical blindness, retinal vasospasm)
      • Hyperreflexia with sustained clonus
      • Convulsions (eclampsia)
      • Stroke
    • Pulmonary
      • Pulmonary oedema
    • Uteroplacement
      • Fetal growth restriction (FGR)
      • Suspected fetal compromise
      • Abnormal umbilical artery Doppler wave form analysis
      • Stillbirth
  • If gestational age is 23-32 weeks or fetal weight is less than 1500grams then contact local service as referral for emergency treatment may be directed to a level 6 maternity service for obstetric assessment
  • Seizures or unexplained syncope
  • Acute mental health concern needing to be seen by acute mental health service or psychiatric emergency centre.
  • Abdominal trauma – GP check with maternity booking hospital level of care required
  • Any concern regarding fetal growth required confirmation with ultrasound (if available) and referral to maternity service as indicated.
  • Change in fetal movement pattern
  • Suspected or confirmed fetal death in utero
  • Any other significant concern

  • Diabetic ketoacidosis
  • Diabetes and severe vomiting
  • Acute severe hyperglycaemia
  • Acute severe hypoglycaemia

COVID-19 UPDATE

To ensure the safety of our patients during the pandemic, we have produced:

Please also view the updated Queensland Clinical Guidelines covering COVID-19. In particular please view:

  • COVID-19 Guidance for Maternity Services
  • Gestational Diabetes Mellitus (screening and diagnosis during COVID-19 pandemic)
  • Additional information is available for Pregnant and Breastfeeding women on the QLD Government website.

Standard referral guidelines

If the referral is incomplete or contains insufficient information it may be returned.

To help with the accurate categorisation of  patients referrals please ensure as much information as possible is provided.

Required

  • Date of referral
  • Patient information:
    • Full name, date of birth, contact details, postal address or contact address (if not the same as usual residence)
    • Allergies (drug/ topical preparation)
    • Aboriginal and Torres Strait Islander status (if applicable)
  • Referring practitioner:
    • Full name, address and contact details
    • Provider number and signature
  • Patient referral information:
    • Detailed reason for referral (including the problem to be assessed, degree of loss of function, pain experienced etc.)
    • 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)
    • Relevant investigations (pathology, radiology, histology etc), preferably results from within last 4 weeks
    • Current medications and doses, prescribed and over the counter (Note any recent changes in drug therapy)

Desirable

  • Relevant psychological and social issues impacted by condition (if applicable)
  • Smoking & alcohol history (if applicable)
  • South Sea Islander status (if applicable)
  • Medicare Number (if applicable)
  • Interpreter requirements (if applicable)
  • Patient status – DVA, Work cover, Motor Vehicle Insurance, ineligible (if applicable)

If sufficient information is not provided you and your patient will be notified in writing that we are unable to clinically categorise and place the patient on an appropriate wait list until this information is received. Once a completed referral has been accepted and categorised you will receive advice that your patient has been placed on the waiting list. Please maintain clinical supervision of your patient’s condition prior to the initial consultation with the specialist. Please notify Central Patient Intake (CPI) of any significant change in their condition.

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • FBC, HepB, Hep C, HIV, Syphilis, Serology, Blood group & antibodies
  • Copy of morphology scan

Significant obstetric history

  • Gravida
  • Para
  • Miscarriage
  • Ectopic

Complete the Maternity referral form and forward it to Metro North Central Patient Intake.

For Royal Brisbane and Women’s Hospital imaging requests, complete the Women’s Imaging Request Form.

For Royal Brisbane and Women’s Hospital dietitian requests, complete the Maternity Dietitian Outpatient Referral form.

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

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