Referral criteria
| Category A Local Expertise | Category B Clinical review, advice and guidance from MMC | Category C Care led by MMC UCLH unless stated otherwise |
|---|---|---|
| Uncomplicated inflammatory bowel disease in remission or inflammatory bowel disease managed in a specialist IBD-obstetric service at a local centre | Complex inflammatory bowel disease without access to specialist IBD-obstetric service at a local centre: • Active disease despite treatment • Biologics • Corticosteroids • Peri-anal disease • Pouch/stoma | Complex pancreatitis (RFH) • Not responding to treatment • Recurrent disease • Hypertriglyceridaemia • IR/surgical intervention |
| Hyperemesis gravidarum | Acute and chronic pancreatitis | Portal hypertension (RFH) |
| Constipation | Treated GI malignancy | Active malignancy |
| Gallstones | Unexplained jaundice | Decompensated liver disease/liver failure/cirrhosis* (RFH) |
| Gastro-oesophageal reflux disease | Acute fatty liver of pregnancy | Liver transplant (RFH) |
| Coeliac disease | Achalasia | |
| Viral hepatitis | Liver infarction/haematoma | |
| Intrahepatic cholestasis (bile acids <100) | Intrahepatic cholestasis (bile acids ≥100) | |
| Cholecystitis | Autoimmune hepatitis | |
| Viral hepatitis | Wilson’s disease | |
| HELLP | Crigler Najjar syndrome | |
| Non-alcoholic fatty liver disease with normal fibroscan and no metabolic complications | Non-alcoholic fatty liver disease with abnormal fibroscan or metabolic complications | |
| Primary sclerosing cholangitis | ||
| Primary biliary cirrhosis | ||
| Haemochromatosis |
Resources
- BSG consensus guidelines on the management of inflammatory bowel disease in adults
- Standards for the provision of antenatal care for patients with inflammatory bowel disease
- The Second European Evidenced-Based Consensus on Reproduction and Pregnancy in IBD
- Intrahepatic cholestasis of pregnancy (Green-top Guideline No. 43)
- EASL Clinical Practice Guidelines on the management of liver diseases in pregnancy