Required information
In order for us to be able to accept your patient for review and treatment, referring GP’s/Medical Specialists are required to provide the following detail in your referral.
Essential information
- full name
- address
- date of birth
- referring GP details
- Medicare number
- previous patient
- cultural considerations
- preferred language and Interpreter
requirements.
Clinical information
Current history:
- LNMP
- EDD
- parity and gravida
- multiple pregnancies
- height and Weight
- pap smear
- BMI female circumcision.
Past history:
- preeclampsia
- stillbirth
- small baby <2800g at term
- preterm birth
- foetal abnormality
- GDM
- placental abruption
- rhesus isoimmunisation PPH >=1000mls
- number of previous caesareans
- mid trimester loss or miscarriage.
Risk factors:
- diabetes
- pre-pregnancy Cervical surgery >2
- LLETZ procedures
- familial genetic disease
- asthma
- anaemia
- epilepsy
- DVT or pulmonary embolus
- haemoglobinopathy
- psychiatric disorders
- hepatitis B or C
- hypertension
- renal disease
- SLE Thyroid disease
- alcohol and other drugs
- smoking
- past medical and surgical history
- medications
- allergies
- shared care request
- social history.
Medical history
Medical history:
- diabetes
- epilepsy
- thalassemia/haemoglobinopathy
- hypertension
- thyroid disease
- current smoker
- asthma
- anaemia
- DVT or pulmonary
- previous cone biopsy.
- high blood pressure
- psychiatric disorders
- heart disease
- illicit drug use
- allergies
- alcohol and other drugs.
Investigations and results
Required:
- FBE
- HIV serology
- syphilis serology
- ferritin
- MSU/urinalysis
- Hb electrophoresis
- hepatitis B and C
- thalassemia
- blood group and antibodies
- morphology ultrasound requires separate referral.
Consider:
- dating ultrasound
- chlamydia
- vitamin D
- early GTT.
Aneuploidy Screening
Discussion occurred
First trimester combined
Second trimester MSST
None invasive prenatal
screening.
Referral process
Populate required information on the maternity referral form then print and fax to the relevant outpatient department on 03 8458 4205.
Step 1
Essential referral content will be checked.
You will be contacted if further information is required.
Please indicate the patient’s preferred model of care on the referral form.
If requesting an urgent review please include relevant detail and results.
Acknowledgment of referral receipt will occur within eight working days.
Step 2
The referral will be triaged by the specialist unit according to clinical criteria and patient preference.
This determines how long the patient will have to wait for their first antenatal appointment.
Step 3
Patients with urgent conditions are scheduled to be seen within 30 days.
Patients are allocated an antenatal clinic appointment.
The date for the appointment will depend on the model of care and clinical acuity.
Both the referrer and patient are notified.
If you have not received a response to your referral within eight working days, please call our central booking office on 03 8458 4111.
Additional information
Outpatient bookings for maternity care at Mercy Hospital for Women and Werribee Mercy Hospital provide the first step in initiating maternity
care for women. The content and detail in your referral are crucial to enable risk assessment, timely bookings of appointments and to
support subsequent communications to enhance continuity of care.
Accurate and up-to- date information will enable us to match patient and GP data for inclusion within hospital computer systems and will
support communication at key points of care.
Missing information (such as estimated date of birth or elevated BMI) will result in delays in processing your patient’s referral. Please include
accurate clinical information to avoid this occurring.
Contact details
Referral contact details
Mercy Hospital for Women
Level 3, 163 Studley Road
Heidelberg Vic 3084
Phone: 03 8458 4111
Fax: 03 8458 4205
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