RT Journal Article
SR Electronic
T1 Development of obstetric-hepatology services: defining optimal care and impact of pregnancy counselling on patient experience
JF Frontline Gastroenterology
JO Frontline Gastroenterol
FD BMJ Publishing Group Ltd
SP 124
OP 131
DO 10.1136/flgastro-2022-102106
VO 14
IS 2
A1 Rahim, Mussarat Nazia
A1 Hedley, Catherine
A1 Frick, Alex
A1 Chung, Yooyun
A1 Penna, Leonie
A1 Long, Lisa
A1 Williamson, Catherine
A1 Heneghan, Michael A
YR 2023
UL http://fg.bmj.com/content/14/2/124.abstract
AB Objective Prepregnancy counselling (PPC) is an important aspect of care for women with chronic liver disease (CLD) and liver transplantation (LT), yet its impact has not been well described. This study aims to assess the experience of women attending a joint obstetric-hepatology PPC clinic in a single-centre unit.Design/methods A retrospective questionnaire-based study in a tertiary unit within the UK where patients who attended the PPC clinic between March 2016 and July 2021 were invited to participate by filling in a questionnaire. Descriptive data and free-text content were subsequently analysed.Results 108 women attended the PPC clinic over a 5-year period. Overall, 58/108 (54%) completed the questionnaire. Principal concerns regarding pregnancy included fears around deterioration in health (66%), maternal death (24%), pregnancy loss (66%), medication effects (60%) and disease transmission (36%). 17/58 (14%) patients felt the presence of multiple doctors was intimidating, however, perceptions improved by the end of the consultation.Overall, 44/58 (76%) respondents felt the clinic helped them reach a decision about pursuing pregnancy. Almost all respondents would recommend the clinic to others. There were no major differences in pregnancy outcomes between those that received PPC and those that did not.Conclusion The PPC clinic facilitates a personalised approach to care and is well received by patients with CLD/LT. It is difficult to elucidate whether attendance alone impacts on pregnancy outcomes; registry data may be better placed at addressing this important question.All data relevant to the study are included in the article or uploaded as online supplemental information. The data that support the findings of this study are available from the corresponding author, MAH, upon reasonable request.