334. Obstetric Internal Medicine in Spain

Abstract

Obstetric Medicine is an unrecognised and little known subspecialty in Spain and Europe. Currently in Spain, interactive clinical and academic forums between internists and obstetricians are limited to local or isolated initiatives. To gather reliable data about the clinical and academic implication of internists on the care of pregnant women with medical disorders in Spain. A web-based survey was sent by email to all members (8000) of the Spanish Society of Internal Medicine in March 2017. Responses were collected for 2 months. We received 260 responses from 167 hospitals in 43 (of 50) Spanish provinces, and 6 abroad. Overall, 62.93% responders belong to a university hospital. For 74.81% of them internists are the doctors most frequently involved in medical disorders in pregnancy, followed by obstetricians (45.74%) and other medical specialists (43.02%). Around 18.82% have a specific unit/clinic of medical diseases in pregnancy at their hospital. Of those, 8 centres deal with various general disorders, another 8 focus on cardiovascular and hypertensive disorders, and 12 on systemic autoimmune diseases. Nearly 20.39% responders receive more than one referral per week from the Obstetrics department; 18.29% are seen by an internist specialised in the field. Similarly, 12.55% of participants have at least a member in their unit involved in teaching and/or research in the field, whereas 14.84% identifies opportunities for specific training around them. Most of responders (92.55%) do not know any society that focuses on medical complications of pregnancy. Despite the fact that internists are frequently involved in the care of pregnant women with medical disorders in Spain, generally they lack training resources, the specific area is not included in their specialty training program and they rarely participate in research/teaching in that field. Formal colaboration between internists and obstetritians, and structured training activities may still be pertinent.