Management of abnormal findings

 

It is the primary responsibility of the maternity provider ordering an investigation to ensure appropriate follow up and management. However, all providers should check that any incomplete or abnormal investigation results or findings have been followed up. This should be clearly communicated and documented on the handheld record.

All providers of maternity care have a responsibility to appropriately manage problems arising during a woman’s pregnancy. If the pregnancy deviates from normal, the community provider should consider referring the woman for hospital assessment or additional clinical consultation.

For immediate clinical advice, GPs are recommended to refer in the following manner according to hospital site.
 

URGENT REFERRALS

 Non-Obstetric or Less than 20 weeks pregnant 

• Emergency Department 

Any woman less than 20 weeks gestation should present to the Emergency Department (at the booking site) for assessment. This includes first trimester bleeding or pain that cannot be appropriately diagnosed and managed in the community.

Any pregnant woman presenting with an urgent non- obstetric condition (eg chest pain, undiagnosed abdominal pain, seizures, unusual migraine) should be referred to the Emergency Department in the first instance for assessment.

More than 20 weeks pregnant 

• DANDENONG HOSPITAL 
The first point of call for immediate clinical advice and review for women greater than 20 weeks pregnant is:

Birth Unit Midwife in Charge P: 9554 8180

If required, the obstetric registrar can be contacted on 9554 1111 Pager 7291.


• CASEY HOSPITAL 
The first point of call for immediate clinical advice and review for women greater than 20 weeks gestation is:

Birth Suite Midwife in Charge P :8768 1755

If unavailable, the On-Call Obstetrician or Staff Obstetrician can be contacted through Main Switchboard: P:8768 1200.


 CLAYTON – Monash Medical Centre (MMC) 
The first point of call for immediate clinical advice and review for women more than 20 weeks pregnant is the Pregnancy Assessment Unit on P: 9594 5032.

If the PAU Registrar is unavailable, the Obstetric On-Call Registrar can be paged via the Main Switchboard on P: 9594 6666.

 
NON-URGENT REFERRALS

The Midwifery Unit Manager at each hospital site can facilitate assistance for shared care affiliates and GP Obstetricians in non-urgent situations.

This may include:
• Organising extra outpatient appointments for additional clinical consultation
• Advice on referral to allied health or psychiatry services
• Arranging non-urgent reassessment of community ultrasound and other pathology results
• Discussion of correct hospital site allocation if the community provider believes the woman has been booked in a site that is not appropriate for her care
 

Midwifery Unit Managers
Monash Medical Centre
P: 9594 2457

Dandenong Hospital
P: 9554 8832

Casey Hospital
P: 8768 1755