Direct to an emergency department with a maternity service for:
- Fetal growth restriction (FGR) detected less than 31 weeks gestation with the likelihood of requiring preterm birth.
Criteria for referral to level 6 public hospital maternity service
- Fetal growth restriction <31 weeks gestation (estimated fetal weight (EFW) or abdominal circumference (AC) less than 3rd centile).
- Estimated fetal weight (EFW) or abdominal circumference (AC) less than the 10th centile with any abnormal doppler ultrasound (umbilical artery doppler pulsatility index (PI) >95 centile, or absent/reversed end diastolic velocity (AEDV), or middle cerebral artery PI <5th centile, or ductus venosus PI >95th centile or absent/reversed a wave, or uterine artery doppler PI >95th centile).
Information to be included in the referral
Information that must be provided
- Ultrasound reports
- Antenatal history
- Maternal serology results.
Provide if available
- Prenatal screening results.
- Toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV (TORCH) test results.
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.
If doppler ultrasound is not readily available in the setting of fetal growth restriction (FGR) <10th centile, contact a level 6 maternity service for specialist advice.
Referral to a level 6 public hospital maternity service is not appropriate for