High-Risk+OB+Referral

Complicated Prenatal Patient Consultation and Referral
Routine prenatal and obstetrical consultations are available 24 hours a day from the OBGYN Department Attendings for concerning conditions or findings, review of prenatal plans, or transfer to the hospital. Either call Labor and Delivery at 925-370-5608 (55608 from most of the clinics) and request to speak to an OB Attending or go to [|www.amion.com] password ccrmc and choose one of the OB on-call to page. Alternatively, inbasket questions can be forwarded to one of the following physicians who have a prenatal clinic in that part of the County:

East County: Grace Cavallaro, Joe Macedo, Sunthara Hay, Lisa Rodelo, Scott Loeliger, Ogo Mbanugo Concord: Cindy Su, Christina Wong Martinez: Judith Bliss, Lisa Rodelo. Ruxi Radu-Radulescu West County: Judith Bliss, Karine Hajyan, Ann Lockhart, Joanna Mandell, Melina Beaton

Patients are scheduled directly into these clinics called **HIGH RISK PREGNANCY** in ccLINK. The Perinatologists do not have access to their inbasket when not in clinic so telephone them when you have a question you think is best answered by Perinatology rather than our OB Attendings. OB Attendings can help advise you on the logistics of carrying out their recommendations.
 * East Bay Perinatal Medical Associates is contracted to provide additional consultation by phone 24 hours per day regarding more complex prenatal and obstetrical conditions. They also provide on-site consultation clinics for complicated cases at the following times:**
 * Pittsburg || 2nd and 4th Wednesday mornings (usually Dr. Janet Goldman) ||
 * Martinez || 4th Wednesday afternoon (usually Dr. David Marinoff or Dr. Janet Goldman) ||
 * West County || 3rd Tuesday afternoon (usually Dr. David Marinoff or Dr. Janet Goldman) ||


 * Guidelines to make a good referral to HIGH RISK PREGNANCY for CONSULTATION (these are NOT transfer clinics)**
 * Make sure you ask //specific questions// that you need answered
 * Consider these as possible subjects of questions:
 * Assess on-going care
 * Follow-up plans
 * Monitoring requirements (amount/timing)
 * Timing of delivery
 * Where should delivery occur
 * If you are following a complex patient and just want the care reviewed, state your concerns and plans so the perinatologist can confirm your plan
 * The patients needs to have a first prenatal visit //before// seeing the perinatologist (can be the same day, but //earlier//)
 * //NO// chart checks in lieu of an appointment (unless approved by a perinatologist) but phone calls instead of appointments for specific questions are encouraged due to limited availability of appointments
 * Do //NOT// send patients needing genetic counseling or level II ultrasound--they must go to the Perinatology Office
 * Do //NOT// send patients just because they are not adhering to a plan or engaged in substance use, unless you really believe that talking to a Perinatologist will be helpful. Consider SBIR, Social work, etc.

Call the EBPMA Office at 510-444-0790 or 510-271-5399, introduce yourself and ask to speak with a perinatologist. The Perinatologists are Jonathan Weiss, Stu Lovett, Ralph DePalma, David Marinoff and Janet Goldman.
 * Getting hold of a perinatologist for phone consultation**

For after hours issues or matters requiring a patient transfer to Alta Bates, call 510-204-1572 (Labor and Delivery at Alta Bates), Introduce yourself as a provider from CCRMC and state you need the Perinatologist on-call. They will give you the number to page.

For transfers, level II ultrasounds, office consultations do not order in ccLINK. Fill out the referral for on their website at [] This form is usually available in most clinics in the paper form. Ask your nurse or Healthy Start to help schedule the appointment. Note that EBPMA has closed their San Ramon office.


 * Genetic Counseling**

Genetic counselors can be reached at the East Bay Perinatal Medical Association offices:
 * Oakland, if CCHP: 510-204-1507
 * Oakland, if MediCal: 510-869-8425


 * What about Diablo Valley Perinatology?**

Diablo Valley Perinatal Associates is located in Walnut Creek near John Muir Hospital. The Perinatologists are Jeff Traynor and Rosa Won. We schedule NT ultrasounds, and anatomy scans there that can not be accommodated at East Bay Perinatology. They require actual Medi-Cal or CCHP (not presumptive). They will schedule follow up ultrasounds without further referral, sometimes on a more frequent schedule than our usual recommendations so be sure to ask patients if they have additional ultrasounds scheduled. If they are seeing the patient for ongoing scans (other than NTs or one anatomy scan) or other care it might make more sense to call them for consultation at 925-891-9033 (24 hours). Also call this number if a clinic to L and D transfer is needed to John Muir Hospital for a preterm patient < 34 weeks. Forms can be found at []