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Useful management information

  • Expect the first hospital visit to be offered between 16-20 weeks unless there are issues requiring more urgent review
  • GP will be responsible for the care until review by maternity service
  • Discuss the Maternity model of care options available across Queensland, these are site specific.
  • Document woman’s preferred model of care – if known or provide information at time for woman to consider options
  • Advise earlier referral if woman requesting midwifery group practice model of care
  • Advise if woman requesting GP Shared Care Model
  • Advise if GP prepared to participate in the GP shared care model (GP’s wanting to participate in a shared care model will need to meet local training and CPD requirements).
  • Advise antenatal, lactation and parenting education preparation and support
  • Recommend routine vaccinations for pertussis and influenza
  • Recommend COVID vaccination as per ATAGI guidelines
  • Consider early low dose Aspirin use if risk factors for pre-eclampsia/IUGR are identified.  Commence before 16 weeks and usually ceased at 36 weeks gestation.

Physiotherapy – indications for referral, consider community referrals or local health pathways

  • Urinary/faecal incontinence
  • Pelvic organ prolapse
  • Significant pelvic joint pain
  • Significant back pain
  • Carpal tunnel syndrome/de Quervain’s Syndrome
  • Inpatient on prolonged bed rest referred by medical team
  • Varicosities

Dietitian – indications for referral – consider community referrals or local health pathways

*NB There is no direct pathway in Metro South for GPs to refer to a Dietician within the Public Hospital, please include relevant clinical concerns which may benefit from Dietetics input (non-exhaustive list below) in the Antenatal referral, and an internal referral may be arranged accordingly. 

  • Gestational diabetes mellitus [no additional referral once referred back to Antenatal clinic].
  • Hyperemesis gravidarum (in-patient only) See: Pregnancy induced vomiting and hyperemesis gravidarum
  • History of Bariatric surgery
  • Body mass index (BMI) <18
  • BMI ≥ 35 (pre-pregnancy BMI >30)
  • Excessive weight gain during pregnancy (10 kg or more at 20 weeks)
  • Young women aged < 17 years
  • Nutrient deficiencies
  • Multiple Pregnancy
  • History of eating disorders
  • History of previous or current alcohol and/or drug abuse

Social Work – indications for referral consider community referrals or local health pathways

*NB There is no direct pathway in Metro South for GPs to refer to a Social Worker within the Public Hospital, please include relevant social concerns which may benefit from Social Work input (non-exhaustive list below) in the Antenatal referral, and an internal referral may be arranged accordingly. 

  • Domestic and family violence
  • Child Protection involvement (current and relevant past history)
  • Substance abuse / drug & alcohol issue
  • Unwanted pregnancy (refer to Termination of Pregnancy CPC)
  • Consistent poor attendance for pregnancy care
  • Multiple social concerns (i.e. a combination of poor social supports, housing and financial issues, significant relationship concerns)
  • New serious health diagnosis for mother or baby during pregnancy
  • Anticipated significant difficulties coping with the baby

Clinican resources

Minimum referral criteria (Does your patient meet the minimum criteria?)

Does your patient meet the 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

If your patient does not meet the minimum referral criteria

  • Assessment and management information can be found on a range of conditions at Brisbane South HealthPathways
  • Consider other treatment pathways or an alternative diagnosis
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

Reason for request

  • 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

Relevant clinical information about the condition

  • 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
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • 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.)


Essential referral information for Antenatal referrals (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
  • Routine antenatal bloods: FBC, Ferritin, blood group and antibody screen, rubella antibody screen, hepatitis B serology, hepatitis C serology, HIV serology, syphilis serology, Mid-Stream Urine for MCS
  • Dating Ultrasound scan (if available)
  • 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/comorbidities (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

Additional referral information for Antenatal referrals

  • 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
  • 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
  • Nuchal Translucency and Morphology Ultrasound scans
  • 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
  • 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 MOC
    • GP Shared Care (Is the GP aligned?)
    • Midwifery Group Practice (MGP)
    • Obstetric Care

Out of catchment

Metro South 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 South 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.

Last updated 21 December 2023