Termination of Pregnancy

Availability

North South North West Statewide

Pre-referral work-up

History

Scope

  • Counselling regarding unplanned pregnancies.
  • Surgical terminations of pregnancy  for  women less than 14 weeks gestation
  • Follow up of failed Medical termination of pregnancy ( MTOP) or medical stable patients with complications of MTOP.

All referrals should comply to referral standards and include in particular:

  • Referral is required for this service and vulnerable women are prioritised.
  • The referrer should describe the reasons for consideration of prioritisation for vulnerability.
  • For example such women might include (not exclusive):
    • victims known or suspected of assault and/or domestic violence
    • social, geographical or financial disadvantage, including those with a Health Care Card
    • women who identify as Aboriginal or Torres Strait Islander
    • women with acute stress or mental illness or other medical illness
    • women with physical or intellectual disability.

Please be sure to include the best contact method for the woman.

Tests

  • FBE
  • Beta hCG
  • Blood Group and antibodies
  • Dating scan

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

Consider referral to clinicians who provide counselling and Medical Terminations of Pregnancy in the community.

If the RHH is unable to accommodate a referral, the woman and/or the referring clinician will be contacted and made aware of alternative options.

Public Health Services - Termination of Pregnancy website

Complications of MTOP

There are two  infrequent situations a prescriber (or other medical practitioner) may encounter despite good planning/procedures. These maybe

1) The stable patient where the MTOP has failed and the uterus still contains the foetus.

In this situation the prescriber/GP is to refer the patient to the RHH clinics. By faxing the referral marked URGENT and that clearly stating it is a Failed MTOP. Fax 6173 0473 Provide explanation and all appropriate information: scans, meds given, dates, BHCG etc vital signs.

2) The unwell/unstable patient who may have excessive bleeding, pain or infection.

The patient may be for example haemodynamically stable but febrile or have excessive pain . Or the patient may have severe PV bleeding and therefore be haemodynamically unstable.

The Prescriber is to provide explanation and refer the patient to the Emergency Department for assessment. The gynaecology registrar will contacted by ED when/as required.

Either fax or provide a letter with the appropriate information already to hand: scans, meds given, dates, bHCG vital signs..

For more information please see the Tasmanian Health Pathways website.

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Public Health Services - Termination of Pregnancy website

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340 Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:
Routine:

Will be seen in turn.