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 and uncontrolled pain or bleeding

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


  • routine cervical screening test
  • women undergoing test of cure for non-16/18 human papillomavirus (HPV)

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • oncogenic HPV with liquid-based cytology (LBC) prediction of:
    • possible high-grade squamous intraepithelial lesion (pHSIL)
    • high-grade squamous intraepithelial lesion (HSIL)
    • possible high-grade glandular lesion
    • adenocarcinoma in situ (AIS)
    • invasive cancer – cervical or endometrial
  • glandular lesion of the cervix on cervical screening
  • suspected adenocarcinoma in situ (AIS)
  • possible high grade glandular lesion on LBC
  • atypical glandular cells of undetermined significance on LBC
  • atypical endocervical cells of undetermined significance on LBC

Category 2 (appointment clinically indicated within 90 days)

  • positive HPV 16/18 and
    • normal LBC and/or
    • low-grade squamous intraepithelial lesion (LSIL)
  • positive HPV not 16/18 and
    • persistent positive HPV not 16/18
      • on 3 consecutive yearly tests aged less than 50 years of age
      • on 2 consecutive yearly tests aged 50 to 69 years
      • or in a person who is:
        • two or more years overdue for screening at the time of the initial screen
        • identifies as Aboriginal or Torres Strait islander
    • women aged greater than 70 years
    • women who are immune deficient e.g., solid organ transplant, or human immunodeficiency virus (HIV) positive patient
  • women undergoing a ‘Test of Cure’
    • positive HPV 16/18
  • history of diethylstilboestrol (DES) exposure in utero regardless of HPV or LBC screening
  • post-menopausal women with any unexplained vaginal bleeding including post-coital
  • unexplained persistent unusual vaginal discharge, especially if offensive and/or blood stained
  • past history of excisional treatment for adenocarcinoma in situ and any abnormal result
  • cervical polyps in post-menopausal women with normal cervical screening

Category 3 (appointment clinically indicated within 365 days)

  • abnormal cervical appearances with normal cytology and bleeding patterns
  • cervical polyps in pre-menopausal women with normal cervical screening

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

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

Due to limitations in infrastructure and resources, the Women's and Children's Hospital 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
  • height/weight
  • BMI
  • onset, duration and course of presenting symptoms e.g. abnormal bleeding (post-coital/intermenstrual)/immunosuppressive therapy
  • menstrual history:
    • cycle day/months
    • days of bleeding
    • blood loss e.g. change of pads or tampons per day/hours
    • previously trialled treatments
  • quality of life concerns including missed work/school/extracurricular activities as a result
  • pelvic examination findings
  • relevant diagnostic/imaging reports including location of company and accession number


  • most recent and any previous abnormal cervical screening results
  • sexually active people complete a sexually transmitted infection screen, including:
    • human immunodeficiency virus and syphilis serology
    • chlamydia and gonorrhoea which requires:
      • endocervical swab for culture and
      • endocervical polymerase chain reaction swab or urine sample

Clinical management advice

A single cervical screening test may be considered for women between the ages of 20 and 24 years who experienced their first sexual activity at a young age e.g., before 14 years, or who had not received the human papillomavirus (HPV) vaccine before commencing sexual activity.

All women less than 25 years of age are considered a high-risk group and should be screened for sexually transmitted infections (STIs).

Post-menopausal women should be considered for the use of oestrogen cream prior to completing a cervical Co-Test (is the combination of HPV testing and cervical screening result).

Women with a positive HPV not 16/18, but normal or low-grade squamous intraepithelial lesion (LSIL) on liquid based cytology (LBC) do not require a referral for assessment. Please complete a repeat cervical screen test (CST) at 12 months and 24 months. If the HPV remains positive and/or LBC remains LSIL.

Specific efforts should be made to provide screening for Aboriginal and Torres Strait Islander women. Please refer to the National Cervical Screening Guidelines for further information.

Women undergoing a test of cure should have annual testing until both the LBC and HPV are negative. At this point routine screening can resume. Routine colposcopic assessment is not required for cases where there are fluctuating results of HPV strains other than 16/18 and/or LSIL.

Clinical resources

Consumer resources