Early pregnancy complications

Early Pregnancy Assessment and Management

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Useful Management Information

This service does not accept referrals for woman over 16 weeks gestation
For unconfirmed pregnancy please consider:
- Completing routine antenatal screening
EPAM Service is available Monday to Friday 8am – 4pm
If out of hours send any unstable patient to emergency department.
If out of hours and stable miscarriage requiring management identified, send referral to service, contact will be made the following day to organise an urgent appointment.

Minimum Referral Criteria

Category 1	Confirmed non-viable pregnancy Incomplete miscarriage requiring management Stable ectopic pregnancy Pregnancy of unknown location Pregnancy of uncertain viability Suspected stable molar pregnancy
Category 2	No category 2 criteria
Category 3	No category 3 criteria
If your patient doesn't meet the minimum referral criteria 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

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

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

Last Normal Menstrual Period (LNMP)
Estimated due date
Past obstetric History including gravida and parity
Weight and BMI
Blood group and antibodies
Full Blood Count
Beta hCG result (consider serial Beta hCG)
Psychosocial risk Factors (eg. Mental Health, Domestic Violence, Substance Use) if relevant
All available ultrasound reports related to this pregnancy

Additional Referral Information

No additional referral information

Send Referrals To

Smart Referrals

Not Available

Internal Referrals

Early Pregnancy Assessment and Management Service (E-blueslips)

Fax

Not available

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