Admission Officer

Queensland Royal Hospital

5 December 2021

Re: Mrs. Julia Smith

Dear Admission Officer,

I am writing to request the immediate transfer of Mrs Julia Smith and her newborn to your
hospital where neonatal resuscitation, premature neonatal care and maternal management can
be provided accordingly.

Mrs. Smith is a 21 year-old female who presented on 05/12/2021 at Cow Bay Primary Health
Clinic where she was admitted for premature active labor. She was 30 weeks of gestation and
had a vaginal delivery of a baby boy weighting 4.1 kg. At birth, APGAR score was 5, the
newborn was cyanosed and not crying but, he started crying after massaging and slapping his
back. Five minutes later, APGAR score was 7 and he was hypothermic and cyanosed.

Mrs. Smith’s labor was significant for elevated blood pressure (140/90 mmHg) which required
Hydralazine. She is from Cyprus and was visiting in-laws in Australia therefore records were not
available. A local midwife visited her monthly for prenatal care. She has not previous hospital
visits or vaccinations. Her family history includes multiple members with diabetes and
hypertension.

I would appreciate if you could admit immediately the newborn to the neonatal intensive care
unit and perform a complete examination by a pediatrician. Mrs. Smith requires risk factor
management and counselling regarding future pregnancies by an obstetrician as well.

If you required further information, please do not hesitate to contact me.

Yours sincerely,

Doctor