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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.

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. 

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

Not applicable.