ENHANCING INTERDISCIPLINARY COLLABORATION IN THE MANAGEMENT OF PREGNANCY IN PATIENTS WITH SYSTEMIC AUTOIMMUNE/AUTOINFLAMMATORY RHEUMATIC DISEASES: THE IMPACT OF JOINT RHEUMATOLOGY AND OBSTETRICS MEETINGS

PV189 / #70

Poster Topic: AS21 - Pregnancy and Reproductive Health

Background/Purpose Management of pregnancy in patients with systemic autoimmune/autoinflammatory rheumatic disease (SARD) requires close collaboration between rheumatologists and obstetricians. However, regular face-to face meeting is not held even academic institutions due to difficulties in scheduling and lack of sufficient participants from obstetric department due to less interests. Objectives Recognizing the need for increased collaboration, monthly interdepartmental meetings were initiated to share information and improve patient outcome. education for young clinicians. The primary goal was to make as needed communication easier and strengthen meticulous collaboration between the rheumatology and obstetrics departments to improve the management of pregnant patients with SARDs.

Methods Joint meetings between the 2 departments were held at a tertiary medical facility. To continue the meeting with sufficient participants, 5 principles were established as follows; 1. Starting at 16:30 sharp on Wednesday and finish by 16:55. 2. Members of rheumatology department comes to Obstetric staff area in time. 3. All cases of infertility treatment, pregnancy, and delivery are discussed and to facilitate the discussion, a designated rheumatology fellow prepares 1 slide for each patient and present all cases. 4. Encouragement to participate on site but option of remote attendance via Microsoft teams is available. 5. Mini-lectures and confirmation of consensus in care are done at the end as far as time allows. At the end of FY2022, a survey of staff in both departments was conducted regarding these meetings. Based on the feedback from the survey, bi-directional mini-lectures on pregnancies complicated by RMDs were initiated starting in FY2023.

Results In FY2022-2023, there were discussions on a total of 197 pregnancy cases, and 10 infertility treatment cases. SLE was the most common background disease among pregnant women, followed by rheumatoid arthritis and antiphospholipid antibody syndrome. There were no serious adverse pregnancy outcomes (APOs) for the mothers, and the 3 cases of premature birth had uneventful postnatal courses leading to discharge. Improvements in interdepartmental collaboration included 1) standardized protocols for corticosteroid coverage and 2) coordinated aspirin prescribing. According to the staff survey, 68.4% felt that their understanding of pregnancy management had deepened and 94.7% felt that interdepartmental collaboration had improved. Based on the results of the questionnaire, mini-lectures for mutual understanding were initiated; a total of 8 lectures were held in FY2023 on the most requested topics.

Conclusions The implementation of joint meetings between rheumatology and obstetrics has greatly enhanced communication and is a critical step in patient care. In the context of progressive work style reforms, the sustained practice of these concise and effective meetings promises not only to deepen mutual understanding among professionals, but also to significantly improve the standard of care for our patients. Looking ahead, this collaborative model sets a promising precedent for interdisciplinary teamwork in health care.