Criteria for referral to level 6 public hospital maternity service

  • Fetal conditions that require a diagnosis to be confirmed
  • Fetal conditions that require the multidisciplinary care available at a level 6 maternity service
  • Fetal conditions where neonatal intensive care (NICU) will be required including for stabilisation pending transfer to a surgical NICU.

Other conditions that should be considered for referral are listed in additional comments.

Information to be included in the referral

Information that must be provided

  • Ultrasound reports
  • Gestational age.

Provide if available

  • Relevant family history
  • Serology tests
  • Genetic testing results
  • Results of any aneuploidy screening (combined screening or non-invasive prenatal testing) and invasive testing (amniocentesis or chorionic villus sampling)
  • Blood group.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Referral to a level 6 maternity service should be considered in the context of the local maternity service system. Referring clinicians should contact the closest level 5 maternity service to discuss options. 

Conditions that should be considered for referral to a level 6 maternity service: 

  • all fetal cardiac abnormalities, including arrythmias
  • fetal skeletal abnormalities
  • fetal brain abnormalities
  • fetal spinal abnormalities
  • fetal hydrops
  • ultrasound abnormalities suspicious of fetal infection
  • fetal anaemia
  • lung lesions: for example, Congenital cystic adenoid malformations
  • fetal tumours 
  • suspected tracheo-oesophageal fistula
  • diaphragmatic hernias
  • abdominal wall defects
  • cleft palate/ lips
  • ambiguous genitalia
  • renal abnormalities: hydronephrosis, agenesis, dysplasia, urinary tract obstruction (including bladder)
  • vascular malformations of fetus or placenta
  • genetic abnormalities requiring expert counselling.

Referral to a level 6 public hospital maternity service is not appropriate for

Not applicable.