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"Poor antenatal care"

About: Joondalup Health Campus / Maternity

(as the patient),

I am currently pregnant with MCDA twins, due to being high risk I was referred to Joondalup hospital immediately to be seen by an obstetrician.

As part of my care, I needed to be scanned every fortnight at Suite 105 with an obstetrician present. My first scan was at 17 weeks and although the scan went well, I felt the obstetrician was rude, never introduced themselves, etc. This was followed by an hour wait to speak with another obstetrician who, I felt, refused to answer any of my and my partner's questions in regards to the pregnancy, they didn’t even seem interested.

From then on I was required to be scanned at the same clinic every 2 weeks with an obstetrician present, due to the high-risk nature of my pregnancy. However the clinic couldn’t fit me in for appointments (even though, as I understand it, they were required to), I was told to go to a standard ultrasound clinic to do my 20-week anatomy scan even though, I believe this goes against procedure. After a lot of back and forth, I was scanned at a different ultrasound clinic that I had to pay for. The sonographer didn’t pick up any issues and there was no obstetrician present to look over the scan.

My next scan at suite 105 with an obstetrician was booked for 22 weeks, 5 weeks after my 17-week scan. Unfortunately, I never made it to that scan. I requested to be seen at a different hospital and got in immediately. The obstetrician at that hospital looked at my results from my 17-week scan noticed some issues, scanned me that day and suspected I had developed TTTS. That hospital was able to get me into their ultrasound clinic 24hrs later where it was discovered I had stage 2 TTTS and will require surgery to attempt to save the lives of both babies, immediately.

Had I not switched providers, I believe Joondalup hospital would have picked up on this issue too late. Very disappointed with the level and of the care I received at Joondalup Hospital. I felt like they didn’t care about me or my babies. Will never go back to them again.  

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Responses

Response from Dr Cliff Neppe, Head of Obstetrics, Deputy Director of Medical Services, Joondalup Health Campus 5 months ago
Dr Cliff Neppe
Head of Obstetrics, Deputy Director of Medical Services,
Joondalup Health Campus

obstetrics and gynaecology docto

Submitted on 19/08/2021 at 11:28 AM
Published on Care Opinion at 11:30 AM


Dear bracebc47,

Thank you for making contact with Care Opinion regarding your recent experience at Joondalup Health Campus (JHC). Firstly, I wish to congratulate you on your pregnancy. However, I acknowledge that facing a high-risk pregnancy can be a very stressful time for parents and I’m sorry to hear how difficult this time has been for you.

Due to the clinical details you shared about your experience, we have been able to identify you and immediately took the opportunity to review your records and provide your feedback to the doctors concerned in order to respond to the issues you have raised. We take the management of all high-risk pregnancies very seriously and thought it may be helpful for you to have a thorough understanding of what we have been able to determine.

You have a monochorionic twin pregnancy which, as you know, is a high-risk pregnancy for which all standard guidelines recommend intensive monitoring and specialist care. The risk of Twin to Twin Transfusion Syndrome (TTTS) is well known in these pregnancies with the risk being highest in the second trimester.

At your 16 week scan at JHC, the specialist in the ultrasound department recommended 2 weekly scans as per standard guidelines, and noted that the babies were on the small side. This information was verbally communicated to you and clearly stated to your managing midwives on the scan report. The relevant management of a monochorionic twin pregnancy was also communicated at the same-day consultation with the obstetric specialist, both to yourself and in a letter to your outside provider.

I am sorry that you felt the obstetrician to be rude and not interested in answering your, or your partner’s questions at the time and want to share that this was not their intention in any way.

At these appointments, you clearly indicated to our specialists that you planned to have your antenatal care, as well as any scans, arranged by your private provider. This was confirmed to us by your provider. Due to respect for patient autonomy, our specialists can make recommendations to you but are not in a position to intervene in management by another provider you have chosen.

We are not able to comment on any of the events under the care of your private provider but assume that the recommended 2 weekly scans were done, which would have included one at 18 weeks.

When you contacted the ultrasound department on 21 July because you had been turned away from your anatomy scan at an outside provider, the department was fully booked and was unfortunately not able to fit you in immediately, however they did provide names of a number of other practices which provide the appropriate specialist obstetric ultrasound service. A follow-up call to your private provider confirmed that a scan had been arranged with another ultrasound practice.

We are sorry to hear that you have developed the complication discussed at your appointments at JHC and realise that this is distressing for you and no doubt made more so by the possibility of different recommendations from different providers.

Your experience underscores the risks of monochorionic twins and the importance of consistent evidence-based antenatal care in these high-risk pregnancies.

We understand that Care Opinion has contacted you privately and provided you with our Consumer Liaison Service’s contact details so you can make contact if you have any questions or would like to meet to discuss your feedback further. We understand that you have not made contact with this service and recognise that it is likely that you have already had your surgery. However, if at any time in the future you wish to speak with or meet us, please do not hesitate to ring 08 9400 9672 or email consumerliaison.jhc@ramsayhealth.com.au. Please be reassured that at all times we strive to deliver high-quality care and I am saddened that the management of your care has left you feeling as though JHC did not provide that.

Thank you for taking the time to provide your feedback and we appreciate you giving us the opportunity to review the care and service we provide. Please accept our best wishes for a healthy pregnancy and safe delivery.

Yours sincerely,

Dr Cliff Neppe

Head of Obstetrics

Deputy Director of Medical Services

Joondalup Health Campus

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