Department of Health

Specialty: Obstetrics
Age group: All

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 less than 31 weeks gestation (estimated fetal weight (EFW) or abdominal circumference (AC) less than the third centile).
  • Estimated fetal weight or abdominal circumference less than the tenth centile with any abnormal doppler ultrasound (umbilical artery doppler pulsatility index (PI) greater than the ninety-fifth centile, or absent/reversed end diastolic velocity (AEDV), or middle cerebral artery pulsatility index less than the fifth centile, or ductus venosus pulsatility index greater than the ninety-fifth centile or absent/reversed a wave, or uterine artery doppler pulsatility index greater than the ninety-fifth 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) less than the tenth 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.

Reviewed 30 May 2025

Statewide Referral Criteria

Contact us

Address
50 Lonsdale Street
Melbourne, VIC 3000

Phone
1300 650 172
National Relay Service

Email
plannedcare@health.vic.gov.au