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Direct to an emergency department that can provide a gynaecology assessment:
- Uncontrolled vaginal bleeding, or if the woman is haemodynamically unstable.
Criteria for referral to public hospital specialist clinic services
- Post-menopausal bleeding with a thickened endometrium (>4mm measured on transvaginal pelvic ultrasound)
- Post-menopausal bleeding with polyp confirmed by imaging
- Post-menopausal bleeding in a woman taking tamoxifen.
Information to be included in the referral
Information that must be provided
- Findings from physical examination
- Most recent cervical screening results
- Transvaginal pelvic ultrasound results. (Transabdominal pelvic ultrasound results can be provided for women who have not become sexually active, are a survivor of sexual assault or have declined a transvaginal pelvic ultrasound.)
- Past medical history (e.g. diabetes, polycystic ovary syndrome)
- Sexually transmitted infections test results.
Provide if available
- Recent human papillomavirus (HPV) and liquid-based cytology (LBC) co-test result
- Weight
- Body mass index.
Additional comments
The Summary and referral information lists the information that should be included in a referral request.
Cervical screening test results may be provided from either self-collected or clinician collected samples.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- Single episode of bleeding with an endometrium (<4mm measured on transvaginal pelvic ultrasound), with negative cervical screening results.