1) Do not routinely test the following biochemistry at 1st ANV
U&E, LFT, Cholesterol
TSH & Vitamin D
Iron studies (BUT continue to routinely test ferritin levels)
2) Do not perform more than three ultrasound scans during a normal pregnancy
3) Do not repeat testing for proteinuria in established pre-eclampsia (see SOMANZ CW list number 3)
Measuring proteinuria is useful as a diagnostic but not as a prognostic criterion for pre-eclampsia. This is because the level of proteinuria does not correlate with the severity of maternal complications in women with pre-eclampsia, nor are these levels useful in determining the timing of delivery. Thus, repeat testing for proteinuria in managing established pre-eclampsia is not recommended, particularly given the availability of superior prognostic models.
4) Do not perform population screening of women for ovarian cancer
5) Do not routinely test FSH levels to establish menopausal status
The diagnosis of perimenopause and menopause does not require laboratory testing in the majority of cases.
The following conditions can be diagnosed without testing serum FSH in otherwise healthy women who are greater than 45 years of age with menopause symptoms.
- Perimenopause based on vasomotor symptoms and irregular periods
- Menopause in women who have not had a period for greater than 12 months and are not using hormonal contraception
- Menopause based on symptoms in women without a uterus
Do not use the following laboratory tests and imaging to diagnose perimenopause in women greater than 45 years:
- Anti Mullerian hormone
- Inhibin A & B
- Antral follicle count
- Ovarian volume
Do not use FSH if a woman is on the combined oestrogen or progestogen contraception or using high dose progestogen.
Consider using an FSH test to diagnose menopause only in the following situations:
- In women 40 – 45 years with menopause symptoms including a change in their menstrual cycle
- Women less than 40 years where a premature menopause is suspected