Background The majority of expectant mothers with diabetes fail to achieve the recommended glycaemic control prior to pregnancy.1 Suboptimal preparation for pregnancy is known to be associated with adverse outcomes.2 Our aim was to develop handheld notes to standardise and enhance pre-pregnancy care for women with pre-existing diabetes.
Methods A multi-professional group designed the record along national recommendations3 to encourage early engagement and enhance communication between primary and secondary care. The 6 month pilot of 160 notes was conducted in 13 hospitals and 5 primary care centres.
Results The notes are an 8 page document4 and include a traffic light system to alert women of the preparations needed before starting a pregnancy. They contain prompts and checklists for clinicians to cover the essential information and management plans. Participants included women with type 1 and type 2 diabetes. The majority of respondents were new to preconception services. All participants thought that the notes were very useful in highlighting preparation and control prior to pregnancy. Two thirds felt the notes helped them to be more involved with planning their care. Most healthcare providers (92%) thought that the notes were helpful in planning care, flowed logically and facilitated documentation.
Conclusions Our new pre-pregnancy notes are a useful tool to make women with diabetes aware of the preparations necessary before commencing a pregnancy. Following the success of the pilot, the record is now being introduced in an increasing number of maternity units providing diabetes in pregnancy care.
Perinatal Institute (2010) – Diabetes in Pregnancy: addressing the challenge in the West Midlands www.pi.nhs.uk/diabetes
Confidential Enquiry into Maternal and Child Health (2007) – Diabetes in pregnancy: are we providing the best care? www.rcog.org.uk
National Institute for Clinical Excellence (2008) – Diabetes in pregnancy: management of diabetes and its complications from pre-conception to the postnatal period.
Pre-pregnancy notes for women with diabetes. (2012) Perinatal Institute. www.preg.info
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