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A multidisciplinary approach to reproductive healthcare in women with rheumatic disease.
Murray, Kieran; Moore, Louise; O'Brien, Celine; Clohessy, Anne; Brophy, Caroline; FitzGerald, Oliver; Molloy, Eamonn S; Mongey, Anne-Barbara; Higgins, Shane; Higgins, Mary F; Minnock, Patricia; Lalor, Joan; McAuliffe, Fionnuala M; Veale, Douglas James.
Affiliation
  • Murray K; Rheumatology Department, University College Dublin and St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. kemurray@hotmail.com.
  • Moore L; Rheumatology Department, Our Lady's Hospice and Care Services, Harold's Cross, Dublin 6W, Ireland.
  • O'Brien C; UCD Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
  • Clohessy A; UCD Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
  • Brophy C; UCD Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
  • FitzGerald O; Rheumatology Department, University College Dublin and St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
  • Molloy ES; Rheumatology Department, Our Lady's Hospice and Care Services, Harold's Cross, Dublin 6W, Ireland.
  • Mongey AB; Rheumatology Department, University College Dublin and St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
  • Higgins S; Rheumatology Department, Our Lady's Hospice and Care Services, Harold's Cross, Dublin 6W, Ireland.
  • Higgins MF; Rheumatology Department, University College Dublin and St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
  • Minnock P; Rheumatology Department, Our Lady's Hospice and Care Services, Harold's Cross, Dublin 6W, Ireland.
  • Lalor J; UCD Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
  • McAuliffe FM; UCD Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
  • Veale DJ; Rheumatology Department, University College Dublin and St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Ir J Med Sci ; 189(1): 237-243, 2020 Feb.
Article in En | MEDLINE | ID: mdl-31129869
ABSTRACT

INTRODUCTION:

Rheumatic disease (RD) patients when family planning must consider fertility, disease activity, and management from preconception to lactation. A clear understanding is necessary, especially for those receiving disease-modifying antirheumatic medications. Previous studies have highlighted unmet needs in the care of women with RDs with reproductive healthcare needs. This study describes the first published standardized reproductive care pathway for women with RDs and the outcomes of this approach. MATERIAL AND

METHODS:

We developed the care pathway with multidisciplinary input from rheumatologists, rheumatology nurse specialists, obstetricians, midwives, maternal medicine specialists, and pharmacists. We identified patients' emotional and healthcare needs, ensured access to expert advice, maintenance of good disease control, and positive reproductive outcomes. We prospectively followed the patients and report the results of the service.

RESULTS:

Ninety-eight women with median age (range) of 35 years (19-48) were assessed. The majority had an inflammatory arthritis. Seventy-six babies were born to 62 mothers. There were 12 miscarriages and one perinatal death. Breastfeeding rates at 6 weeks were low (28%).

CONCLUSION:

We describe the first published evidence-based integrated multidisciplinary reproductive care pathway for women with RDs and the results of this approach. Seventy percent of women successful in trying to conceive delivered a healthy baby, and 90% of patients were 'very satisfied' with the service.
Subject(s)
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rheumatic Diseases / Fertility Type of study: Guideline Limits: Adult / Female / Humans / Middle aged Language: En Journal: Ir J Med Sci Year: 2020 Type: Article Affiliation country: Ireland

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rheumatic Diseases / Fertility Type of study: Guideline Limits: Adult / Female / Humans / Middle aged Language: En Journal: Ir J Med Sci Year: 2020 Type: Article Affiliation country: Ireland