069 A review of the outcomes of women attending for pre-conception counselling at the Sheffield combined obstetric and rheumatology clinic, 2002 to 2013

Smith, Ruth; Kilding, Rachael; Kuet, Kar-Ping; Fairlie, Fiona; Jokhi, Roobin; Bonnett, Tess; Smith, Marie; Akil, Mohammed

doi:10.1093/rheumatology/key075.293

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“…When comparing our findings with published data from clinics using similar service models in Sheffield and London, we found that our live birth rates are significantly higher than the results from the Sheffield clinic (28 of 41 vs 102 of 105, Sheffield vs Manchester) and comparable to results from the London clinic (99 of 102 vs 102 of 105, London vs Manchester) [ 31 , 32 ].…”

Section: Discussionsupporting

confidence: 65%

Pregnancy outcomes of a joint obstetric and rheumatology clinic in a tertiary centre: a 2-year retrospective study of 98 pregnancies

Hum

David

Lau

et al. 2022

Rheumatology Advances in Practice

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Objectives The purpose of this study is to describe the maternal and foetal outcomes in patients with inflammatory rheumatic diseases (IRDs) attending a joint rheumatology and obstetric clinic in the United Kingdom. Methods Electronic records of 98 patients attending the joint rheumatology and obstetric clinic between Jan 2018-Jan 2020 were analysed. Data on patient demographics, characteristics (including age, ethnicity, diagnosis, and medications taken during pregnancy), pregnancy outcomes (miscarriage, stillbirth, livebirth), maternal complications (infection, postpartum haemorrhage (PPH), pre-eclampsia), and foetal complications (sepsis, congenital heart block (CHB), prematurity, and low birthweight), were tabulated. Subgroups of patients based on maternal diagnosis, medications, and Ro/La antibody status were similarly described. Results The cohort was found to be predominantly Caucasian women above the age of 30, diagnosed with a connective tissue disease. Of 98 pregnancies, 97% (n = 95) resulted in a livebirth, with only 2% resulting in miscarriage (n = 2), and 1% in stillbirth (n = 1). The median age of gestation was 38 (IQR 37-39), and the majority of patients had a normal vaginal delivery (35%, n = 34), whilst 30% had emergency caesarean-sections (n = 29). Median birthweight was 3120g (IQR 2690-3410). The most common maternal complications were PPH (56%, n = 54) and infection (22%, n = 21). The most common foetal complications were prematurity (23%, n = 22) and low birthweight (17%, n = 16). Conclusion We report favourable outcomes from this service model, including a high live birth-rate, low miscarriage rate, and a high median birthweight. With limited reported data of pregnancy outcomes from joint obstetric/rheumatology clinics, this service model may be beneficial in other centres.

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Section: Discussionsupporting

confidence: 65%