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.
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