Antenatal Shared Care Companion — GP Decision Support

Section one

Patient profile

First day of last menstrual period

Calendar picker · auto-calculates GA & EDD

Maternal age (years)

Gestational age (weeks)

Auto from LMP · override if USS-dated

Estimated date of birth

LMP + 280 days

Height (cm)

Weight (kg)

Parity (G P)

BMI: — kg/m²

Blood group

Ethnicity (GDM risk)

Section two

Clinical risk factors

Previous GDM or baby ≥4.5kgAuto-flags early HbA1c

PCOS or family history of T2DM (1st degree)

Previous pre-eclampsia, chronic HTN, CKD, autoimmune, multiple gestation

Preterm birth risk: prev. PTB <35w, mid-trimester loss, cone biopsy ×2Auto-requests TV cervical length

Mental health history: depression/anxiety, prev. PND, current medication

Previous Caesarean sectionTriggers 36w obstetric review re. mode of birth

Folate 5mg indication: prev. NTD/family history, pre-existing DM, anticonvulsants, BMI >35

Currently smoking / vaping / using substances

Quick reference

Diagnostic thresholds · Always visible

Gestational diabetes

First trimester HbA1c	≥ 41 mmol/mol (5.9%)
OGTT fasting	≥ 5.1 mmol/L
OGTT 1-hour	≥ 10.0 mmol/L
OGTT 2-hour	≥ 8.5 mmol/L
BGL targets — fasting	≤ 5.0 mmol/L
BGL targets — 1hr post-meal	≤ 7.4 mmol/L

Routine OGTT 24–28 weeks. Early HbA1c if high risk (BMI >30, age ≥40, prev GDM, PCOS, ethnicity, prev macrosomia, family Hx, PCOS, antipsychotics/corticosteroids).

ii.

Hypertension & pre-eclampsia

Hypertension	≥ 140/90 mmHg
Significant rise	+30/15 mmHg from baseline
Proteinuria (PCR)	≥ 30 mg/mmol
Dipstick protein	≥ 2+
Aspirin prophylaxis	100–150mg nocte from 12w
PlGF screening	11+0 to 13+6 weeks

Refer to PAC: BP ≥140/90 + symptoms, abnormal pathology, IUGR or proteinuria. Severe range BP ≥160/110 — urgent.

iii.

Anaemia in pregnancy

Hb (T1 / T3)	< 105 g/L
Hb (T2)	< 110 g/L
Iron deficiency (ferritin)	< 30 µg/L
Oral iron (deficiency anaemia)	100–200mg elemental/day
Oral iron (deficiency w/o anaemia)	20–80mg elemental/day
IV iron — consider if	Hb <100 >36w OR Hb <90 >32w

Reassess Hb + ferritin 4 weeks after starting oral iron. IV iron NOT before 13 weeks. Take iron away from dairy/tea/multivitamins.

iv.

Anti-D protocol (Rh negative)

Free fetal DNA Rh D	From 15 weeks
Sensitising event <12w	250 IU (625 if multiple)
Sensitising event ≥12w	625 IU + FMH ≥20w
Routine prophylaxis	625 IU at 28 + 34 weeks
Postnatal (baby Rh+)	625 IU within 72h
Repeat antibody screen	Before 28w dose

No Anti-D if fetus confirmed Rh negative on NIPT. Cord blood at birth always confirms neonatal Rh. Threatened miscarriage is NOT a sensitising event.

Scan & screening timings

Dating USS (ideal)	7–8w (CRL ≥10mm)
NIPT (blood)	From 10 weeks
CFTS bloods (PAPP-A, βhCG)	10+0 to 13+6w
Nuchal translucency USS	11+3 to 13+6w
PlGF (early PE screen)	11+0 to 13+6w
Free fetal DNA Rh D (if Rh−)	From 15 weeks
Morphology USS	18–22 weeks

NIPT preferred over CFTS when affordable. Carrier screening Medicare-funded once per lifetime. Refer Mater MFM for CVS/amnio.