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Audit of preconception advice to women of childbearing age with conditions likely to affect the outcome and course of pregnancy
  1. SM Vashishtha,
  2. K Upadhyay
  1. Wrexham Maelor Hospital, Wrexham, UK

Abstract

The Confidential enquiry into maternal and child health published a report titled ‘Saving mothers’ lives 2003–2005 in December 2007. It made 10 top recommendations. The first of these recommendations advised that all women of childbearing age who have pre-existing serious medical and mental health conditions which could be aggravated by pregnancy should receive preconception counselling and support.

The authors decided to audit the quality of advice given to this group of women who attended our hospital. It was an opportunistic audit of 50 women of childbearing age in the antenatal clinics and wards, postnatal wards and those attending specialist medical outpatient clinics. A questionnaire was devised asking them about advice specific to their condition as well as general advice regarding alcohol, smoking, medications etc.

The results show that almost all women with pre-existing diabetes had received some advice. About 75% of women with epilepsy and 60% of those with thyroid disorders had also received some counselling. In contrast only about 15% of women with serious mental illness, body mass index >30 and renal and cardiovascular problems had ever been given such advice.

General practitioners were the most frequent medium imparting the advice followed by consultants. Majority of women had received advice on folic acid in pregnancy.

The results show a need to increase awareness of such counselling among all healthcare professionals as well as patients.

As a result of this audit a local action plan has been developed to improve multidisciplinary communication. A re audit is planned in a year's time.

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