Introduction:
Gold Coast University Hospital (GCUH) is a tertiary referral hospital providing comprehensive maternal care with approximately 5000 births per year. The obstetric medicine service at GCUH fully established in 2023. We aimed to audit outpatient referrals to evaluate service provision and outcomes.
Methods:
We conducted a retrospective analysis of outpatient referrals received between 1st January 2024 and 17th January 2025. Data collected included maternal demographics, referral indication, referral outcomes, referrer specialty, delivery and neonatal outcomes.
Results:
474 referrals were received with 92% referred during pregnancy, 6% postpartum and 2% preconception. Mean maternal age was 30.9years. Obstetrics and maternal foetal medicine accounted for the majority of referrals. The most common medical issues for referral were haematological (n=98, 20.5%), endocrine (n=89, 18%), and cardiac conditions (n=75, 15.7%).
A total of 454 deliveries were recorded with 50.7% by caesarean section. The median gestational age at delivery was 38 weeks and 2 days, with a preterm birth rate of 14.5%.
Among the live births, 77.6% neonates were clinically well, 11.5% required neonatal intensive care unit admission and 8.8% special care nursery admission. The perinatal mortality rate was 1.6% comprising four intrauterine foetal deaths and three neonatal deaths. Additionally, there were nine miscarriages and three terminations.
Conclusion:
Our obstetric medicine service manages a number of medically complex and high-risk pregnancies, highlighting the importance of a dedicated obstetric medicine service within a tertiary maternity centre. Further analysis of referral distribution by postcode may help identify geographical patterns of service utilisation and inform future service planning.