P41 Inflammatory bowel disease in pregnancy: benefits of multiprofessional working

Abstract

<h3>Introduction</h3> Pregnant women with inflammatory bowel disease (IBD) are more likely to have complex pregnancies with adverse maternal and neonatal outcomes. A new multi professional service encompassing both gastroenterology and maternity staff was established at West Middlesex University Hospital(WMUH) in March 2020, with the focus of improving care for pregnant women with inflammatory bowel disease (IBD). Discussion on every newly pregnant woman with IBD has been incorporated into the already well established weekly IBD multidisciplinary team meeting (MDT).Aim of this service was to improve patient care against MBRRACE-UK recommendations and standards set by the British Society of Gastroenterology (BSG) and British Maternal and Fetal Medicine Society position statement released in September 2019. <h3>Methods</h3> From the prospectively completed Obstetric Medicine Clinic database at WMUH, we identified all women with IBD attending this clinic between January 2017 and January 2022.Two cohorts were compared, according to whether their first clinic visit was before or after March 2020, with the later cohort comprising women receiving the newly established care from the Obstetrics IBD MDT. Data were collected from all the relevant aspects of the electronic patient record. <h3>Results</h3> 101 women were identified, 71(70.3%) in the first cohort and 30(29.7%) in the second cohort. The mean age was 32.8 years (22 to 50years) and 37(36.6%) were primigravidas. The standards of care recommended by the BSG position statement were audited as displayed in table 1. <h3>Conclusions</h3> The Obstetric IBD service is lead by an IBD gastroenterologist and maternal medicine consultant alongside trainees, IBD specialist nurse and pharmacist, colorectal surgery and radiology. This audit demonstrates that the introduction of this service is associated with improvements in care and increased adherence to national standards for pre pregnancy planning and folic acid, biologic therapy, birth options and breastfeeding. Initiation of the Obstetric IBD service required enthusiasm from all parties, but no specific financial input or changes to working patterns beyond adjustment to the format of the well-established weekly IBD MDT. This should be achievable in all hospitals. The BSG position statement is a welcomed development in the provision of Obstetric Medicine services for women with IBD in pregnancy.