N32 Outcome of joint IBD Obstetrics clinic in East Kent Hospital NHS Trust

Abstract Background IBD affects 2-3% of women in reproductive age group. Pregnant women often have concerns over IBD medications leading to non-compliance, possible IBD flare and potential risks such as miscarriage preterm birth, Small for Gestational Age (SGA), and increased rate of caesarean-section (Wolloff et al, 2021). IBD nurses find pregnancy flare challenging to manage without input from Obstetricians. Hence a joint IBD Obstetric clinic was started in QEQM Hospital in 2023 to provide joint holistic care for pregnant mothers with IBD. We analysed the outcome prospectively. Methods Women who were pregnant and identified to have IBD were referred to the joint Obstetric IBD clinic which happened twice a month. All women are seen jointly there and a plan of care is made jointly, including disease management, flare plans and follow-up care. A database on Excel was used to analyse the outcome of pregnancies. A questionnaire was created where patients can comment and make suggestions. Results From January 2023 to September 2025, 35 pregnant women were reviewed and 26 women delivered. From these, 50% had UC and 50% CD. One third (34.6%) had a flare and treatment included steroids, 5ASA both oral or rectal or diet (Table 1). Approximately 50% of them delivered vaginally (10/26), 13 had emergency c-section for various reasons including failure to progress and fetal distress. 10% (3/26) were small for gestational age and 10% were delivered preterm. Post-partum flare was diagnosed in 23% (6/26) of which 4 had flare during pregnancy (Table 2). From the feedback questionnaire, women who replied to it, expressed that they benefited from IBD nurse presence in the Obstetric clinic, felt confident deciding management with plan made jointly for the delivery and possible outcomes. The main request was to extend to other sites due to difficulties in transport. Conclusion Our preliminary study in regards providing joint care for pregnant IBD women has shown very positive outcome. IBD flare was promptly identified and managed, caesarean section was comparable, Neonatal outcome showed no adverse outcome and the preterm rate was comparable to that of other pregnant mothers. The clinic suggest that it is feasible and safe to deliver a joint IBD service with Obstetricians and IBD specialist nurse. This also allowed IBD nurses to improve knowledge and confidence when advising outside of the joint clinic. References: Wolloff, S., Moore, E., Glandville, T., Limdi, J., Kok, K. B., Fraser, A., . . . Selinger, C. (2021). Provision of care for pregnant women with IBD in the UK: the current landscape. Frontline Gastroenterology. Selinger, C., Carey, N., Cassere, S., et al. (2020). Standards for the provision of antenatal care for patients with inflammatory bowel disease: guidance endorsed by the British Society of Gastroenterology and the British Maternal and Fetal Medicine Society. doi:10.1136/flgastro-2020-141459 Conflict of interest: Abreu, Beatriz: No conflict of interest Rajasri, Aylur: No conflict of interest