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Home | Articles | Admission | Obstetrics & Gynaecology/Medicine Admission Agreement

Obstetrics & Gynaecology/Medicine Admission Agreement

Last updated 28th March 2022

This is not a list of all possible presentations but aims to cover conditions where there may be uncertainty as to which team should look after the patient.

General Principles

  1. Post-procedure complications wihch occur soon after the procedure and are thought to be direct sequelae of that procedure should be referred to the specialty responsible.  Exceptions would include a new medical problem arising de novo.
  2. Recurrent problems or patients already under specialty care for the same issue should be referred back to that specialty, unless there is a reason to believe that is no longer appropriate.
  3. This document is a guideline, but there will always be exceptions.  All decisions about placement must be made with the patient’s well-being as the top priority.  Any deviation from this guideline should be agreed between teams directly at senior level and not left for the referrer to resolve.
  4. Pregnant women admitted under Medicine should be reviewed by Obstetric Team and MEWS chart for Obstetrics should be used.  Patients should not be discharged without informing the Obstetric Team to arrange ANC follow-up (phone discussion may be sufficient).
  5. Risk of VTE should be assessed in all pregnant women, according to RCOG guidelines and advice regarding thromboprophylaxis should be sought from the Obstetric Team.

Obstetrics & Gynaecology Will Accept the Following

  1. Suspected or confirmed PE in pregnant women beyond the first trimester (ie after 14 weeks) and up to 4 weeks post-partum (exception is unstable patients who should be admitted to CCU under the care of the Intensive Care team, with input from Obstetrics and Gynaecology).
  2. Any evidence of pre-eclampsia
  3. Vaginal bleeding
  4. Patients with local or surgical complications of gynaecological malignancy

Medicine Will Accept

  1. Medical complications of treatment for Gynae malignancy, including treatment side-effects
  2. Neutropenic sepsis

Agreed by Dr Salma Saad, Clinical Director for Obstetrics & Gynaecology; Dr Sian Finlay, Clinical Director for Medicine; Ms Angie Adams, Clinical Midwifery Manager.