Referral to emergency
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- acute/severe pelvic pain
- ectopic pregnancy
- inevitable and/or incomplete abortion
- significant or uncontrolled vaginal bleeding
- suspected systemic infection
- suspected retained products of conception, post-spontaneous or post-operative abortion
- unstable molar pregnancy
Please contact the gynaecology on-call registrar to discuss your concerns prior to referral.
For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.
Northern Adelaide Local Health Network
- Modbury Hospital (08) 8161 2000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Women's and Children's Health Network
- Women’s and Children’s Hospital (08) 8161 7000
Exclusions
- less than 2 miscarriages
Triage categories
Category 1 (appointment clinically indicated within 30 days)
- nil
Category 2 (appointment clinically indicated within 90 days)
- nil
Category 3 (appointment clinically indicated within 365 days)
- recurrent miscarriage
For more on outpatient referrals, see the general referral information.
Central Adelaide Local Health Network only accept referrals for people greater than 18 years of age.
Due to limitations in infrastructure and resources, the Women's and Children's Hospital cannot accommodate referrals for individuals with a body mass index (BMI) equal to or greater than 45, as well as individuals over the age of 69 years of age.
Essential referral information
Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
- identifies as Aboriginal and/or Torres Strait Islander
- relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
- interpreter requirements
- past medical/surgical/obstetric/psychosocial history
- fertility/pregnancy history
- current medications and allergies, including hormone replacement therapy
- onset, duration and course of presenting symptoms
- menstrual history:
- cycle (day/months)
- days of bleeding
- blood loss e.g. change of pads or tampons per day/hours
- height/weight
- BMI
- blood pressure trends
- abdominal examination findings
- pelvic examination if sexually active
- trans-vaginal/pelvic ultrasound
Pathology
- complete blood examination (CBE)
- beta-human chorionic gonadotropin (ßhCG)
- karyotype
- anti-cardiolipin antibodies
- lupus anticoagulant
- thyroid function tests (TFTs)
- antithyroid antibodies
- an up-to-date cervical screening test as per the cervical screening guidelines>
Sexually active people
Complete a sexually transmitted infection screen, including:
- human immunodeficiency virus and syphilis serology
- chlamydia and gonorrhoea which requires:
- endocervical swab for culture and
- endocervical polymerase chain reaction swab or urine sample
Additional information to assist triage categorisation
- relevant diagnostic/imaging reports including location of company and accession number
Clinical management advice
Recurrent miscarriage is defined as more than two miscarriages. It is recognised that after two miscarriages, there may be an increased chance that there could be a specific or recurring underlying cause for this. The clinic aims to identify the cause of the repeated pregnancy losses and investigate and manage appropriately.
Clinical resources
- Australian Indigenous Health Info Net - Central Australian Aboriginal Congress: Women's Business Manual for Remote and Rural Practice 7th Edition
- Australian Medical Association - New Stolen Generation resources for GPs
- Royal Australian College of General Practitioners - Recurrent Pregnancy Loss: A Summary of International Evidence-Based Guidelines and Practice