Maternity care of women with complex medical needs.

Abstract

Background: Monash Medical Centre, Southern Health (MMC) provides maternity care to women with complex medical conditions including inherited metabolic disorders, thalassaemias and sickle cell disease, cystic fibrosis, severe autoimmune disorders, renal and cardiac disease. Women are referred for pre-pregnancy counselling and obstetric care when pregnant. Clinically unstable women can birth in the coronary or intensive care units. Managing high-risk pregnancies requires good communication and coordinated care. Co-location of services has great benefits for the mother, her baby/babies and family. This presentation describes some of the challenges of caring for these women. Method(s): Hospital databases were accessed to identify numbers of women and types of medical conditions managed at MMC. Result(s): 190 women were case managed through the Maternal Fetal Medicine unit. This presentation details pregnancy management, where women birthed, gestation, the condition of babies and whether transfer to the neonatal intensive care unit was required. Conclusion(s): Women with complex medical needs should be referred to specialist multidisciplinary care with access to intensive care, coronary care and dialysis units to maximise the possibility of a favourable outcome for the mother and her infant, where a mother and her baby can be cared for together.