Neonatal test page

Important information

This referral pathway is for people who are pregnant and experiencing pelvic girdle or low back pain, and may benefit from advice, education or physiotherapy. If you are not pregnant, but experiencing back pain, please consult your GP regarding appropriate referral pathways to physiotherapy.

If you are contacting us about low back/ pelvic girdle pain and/ or leg pain and you have recently (within the last two weeks) or suddenly developed any combination or number of these warning signs:

• Loss of feeling/ pins and needles between inner thighs or genitals
• Numbness in or around your back passage or buttocks
• Altered feeling when using toilet paper to wipe yourself
• Increasing difficulty when you try to urinate
• Increasing difficulty when you try to stop or control the flow of urine
• Loss of sensation when you pass urine
• Leaking urine, or recent need to use pads
• Not knowing when your bladder is either full or empty
• Inability to stop a bowel movement or leaking
• Loss of sensation when you pass a bowel motion
• Change in ability to achieve an erection or ejaculate
• Loss of sensation in genitals during sexual intercourse;

DO NOT COMPLETE THIS FORM and immediately contact NHS 111 reporting your symptoms

If you have any of the following:

• Unexplained weight loss (more than 5% of your bodyweight over the last 6-12 months)
• Night sweats
• Fever/ feeling generally unwell
• New/ uncontrolled temperature and you are less than 12 weeks pregnant
• Have recently become unsteady on your feet

DO NOT COMPLETE THIS FORM and make an appointment with your GP or call NHS 111 reporting these symptoms.

However, if you have discussed these symptoms with your GP/ NHS 111 and have been told no further investigation is needed, then please continue to complete this form.

If you have any of the following:

• New onset of bleeding
• New and uncontrolled temperature and are more than 12 weeks pregnant
• Ruptured membranes/ broken waters
• Abdominal pain
• Contractions
• New itching, particularly of feet/ hands
• Reduced foetal movements

DO NOT COMPLETE THIS FORM and contact Maternity Triage reporting these symptoms.

About you

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Which trust have you booked your pregnancy with?

Please Select An Option Medway NHS Foundation TrustMaidstone and Tunbridge Wells NHS TrustDartford and Gravesham NHS TrustEast Kent Hospitals University NHS Foundation

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