Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • acute abdominal pain/shock

Please contact the gynaecology on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Women's and Children's Health Network


  • implanon removal

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • intrauterine contraceptive device (IUCD) intra-abdominal - location confirmed on imaging

Category 2 (appointment clinically indicated within 90 days)

  • IUCD embedded in the myometrium - location confirmed on imaging

Category 3 (appointment clinically indicated within 365 days)

  • IUCD strings not visible - location confirmed on imaging

For more on outpatient referrals, see the general referral information.

All referrals for people less than 16 years of age, or those less than 18 years with intellectual disabilities, complex medical conditions, primary amenorrhea, pubertal delay, or Mullerian anomalies are to be sent to Women’s and Children’s Hospital (WCH).

Central Adelaide Local Health Network only accept referrals for people greater than 18 years of age.

Due to limitations in infrastructure and resources, the WCH cannot accommodate referrals for individuals with a body mass index (BMI) equal to or greater than 45, as well as individuals over the age of 69 years of age.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • for adult patients, relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • for paediatric patients, identify within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • past medical/surgical/obstetric/psychosocial history
  • current medications and allergies
  • hormonal contraception use
  • onset, duration and course of presenting symptoms/attempts made to remove the device
  • menstrual history:
    • cycle day/months
    • days of bleeding
    • blood loss e.g. change of pads or tampons per day/ hours
    • previously trialled treatments
  • height/weight
  • body mass index (BMI)
  • pelvic ultrasound (US) confirming the location
  • abdominal x-ray, device location not confirmed on US

Sexually active people

Complete a sexually transmitted infection (STI) screen, including:

  • human immunodeficiency virus (HPV) and syphilis serology
  • chlamydia and gonorrhoea which requires:
    • endocervical swab for culture and
    • endocervical polymerase chain reaction (PCR) swab or urine sample

Clinical management advice

If you have concerns that the contraceptive device is not appropriately located please ensure an alternative form of contraception is commenced.

Complicated intrauterine contraceptive device (IUCD) removal is defined as:

  • strings not visible
  • device suspected to be embedded in the myometrium
  • intra-abdominal device

Implanon insertion removal is defined as:

  • inability to clinically locate device on palpation

Many private radiology practices offer complicated implanon device removal in the community, although they may charge a fee (gap) for this service. It is advisable to contact your preferred radiology service for further information.

The outpatient hysteroscopy service at Modbury Hospital offers a ‘see and treat’ option for removing IUCD where the strings are not visible. Please contact the gynaecology outpatient service for further information.

Clinical resources

Consumer resources