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 uncontrolled bleeding

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

Exclusions

  • single episode of post-coital bleeding with normal cervical screening test and liquid based cytology without oncogenic human papillomavirus

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • nil

Category 3 (appointment clinically indicated within 365 days)

  • recurrent or persistent unexplained post-coital bleeding with normal cervical screening test (Co-Test)
  • recurrent or persistent post-coital bleeding and ectropion cervix

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
  • current medications and allergies
  • past medical/surgical/obstetric/psychosocial history
  • onset, duration and course of presenting symptoms
  • menstrual history:
    • cycle, day/months
    • days of bleeding
    • blood loss
    • previously trialled treatments
  • height/weight
  • BMI
  • blood pressure trends
  • abdominal examination findings
  • pelvic examination including speculum exam findings
  • trans-vaginal/pelvic ultrasound
  • relevant imaging and reports including location of company and accession number

Pathology

  • complete blood examination (CBE)
  • beta-human chorionic gonadotropin (ßhCG)

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
  • cervical Co-Test

Clinical management advice

Post coital bleeding is defined as persistent non-menstrual bleeding that occurs within 24 hours of vaginal intercourse.

Concerning features may include:

  • women greater than 35 years of age
  • frequent and heavy post coital bleeding
  • abnormally appearing cervix
  • no previous cervical screening test
  • active smoker

Clinical resources

Consumer resources