Pregnancy day assessment centre

Introduction

For some women, complications arise during pregnancy which require close and frequent surveillance. Wherever possible, this surveillance is done in the Pregnancy Day Assessment Centre (PDAC), where intensive maternal and fetal monitoring can be undertaken without requiring overnight admission to hospital. The most common reason for referral to PDAC is high blood pressure in late pregnancy. These women usually have a good pregnancy outcome, but need to be watched more closely in case medication becomes necessary or pre-eclampsia develops. 

Pre-eclampsia is a serious complication in pregnancy which can affect both the mother’s and baby’s health, and sometimes leads to preterm birth. Although high blood pressure complicates up to 10% of pregnancies, pre-eclampsia occurs in only 4% of Australian women. The PDAC is an important facility that helps distinguish those women with preeclampsia from those with high pressure blood pressure alone. 

Our Service

Women with suspected preeclampsia are typically admitted to PDAC for a four-hour period, during which they will have blood tests, urine testing, fetal monitoring and ultrasound to ensure safety of both mother and baby. The obstetric team then develops personalised plan for ongoing management and follow up with the woman. 

PDAC also provides a day stay service for intravenous rehydration in cases of severe vomiting in early pregnancy, and for women requiring intravenous medical treatments such as iron infusions.  Women having an induction of labour may also be admitted to the PDAC for pre-labour cervical preparation with prostaglandins or balloon catheter. 

The PDAC operates Monday to Saturday and offers comprehensive maternal and fetal assessment including fetal heart rate monitoring (cardiotocography, CTG), and ultrasound. This service is provided for all public and private patients at Mercy Hospital for Women by the midwives in the Fetal Surveillance Unit, with medical support from the Maternal Fetal Medicine team if required.

For clinicians - who can be referred?

The PDAC takes both booked and ‘walk up’ appointments for women with high blood pressure, or those who require regular outpatient follow up for conditions such as preterm premature rupture of the membranes. The PDAC midwives also administer prostaglandins or insert cervical balloons for women undergoing induction of labour who require cervical ripening.  Booked referrals are welcome for iron infusions, hyperemesis rehydration or other therapies requiring intravenous therapy over several hours such as immunoglobulin infusions. This Monday - Friday walk-up service ensures timely and responsive surveillance; Saturday assessments are by appointment only on (ph) 03 8458 4267.