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Specialist Maternity Team Win Prestigious Award

Our team with Parliamentary Under Secretary of State for Public Health Anne Milton MPOne of our specialist maternity teams are today celebrating after collecting a prestigious award from Parliament!  Our joint cardiac/maternity team won Highly Commended in the 'Best example of a service for women with complex medical needs in pregnancy' category at the All-Party Parliamentary Group (APPG) Maternity Services Awards, for their work caring for women with complex heart disease throughout pregnancy, the leading cause of maternal mortality.

The service was set up in 2004 by Dr Sarah Vause, Consultant Obstetrician and Dr Bernard Clarke, Consultant Cardiologist, with the support of a specialist midwife.  Since 2004, the amount of new referrals we receive has doubled, increasing from 43 in 2004 to 86 in 2010 and there have been no unexpected
admissions of our patients to Intensive Care or maternal deaths. 

Dr Sarah Vause said:  "The thing that we are most proud of is knowing that there are several women with severe heart disease who now have children, who would not have embarked on, or survived the pregnancy had it not been for the service we provide.

"There are many more women where our input resulted in better outcomes for the woman or the baby, either by prolonging the gestation or by ensuring that the woman was delivered at Saint Mary's where all the facilities and professionals are in one place and have expertise in managing women with very high risk pregnancies.

"We were absolutely thrilled when our team won this award.  In Manchester we are fortunate enough to have the people and the facilities to provide care for this high risk group of women and their babies. The award recognises the work of all the members of the team."

Our particular strength, and something which is unique to the North West, if not nationally, is the location of a wide range of disciplines on one site.  In most other tertiary centres the maternity unit is situated in a different building, and often on a different site, from the cardiac centre. On one site, in one building, we have a maternity unit with high dependency facilities, Newborn Intensive Care Unit and the Manchester Heart Centre; with cardiologists, cardiac surgeons, cardiac anaesthetists, haematologists, radiologists and cardiac technicians.  This strength enables us to care for the sickest women and their babies in life threatening situations, at any time of the day or night.

This was further strengthened when we moved the clinic into an antenatal setting whilst still ensuring that women were able to see several different specialities in one place, during one appointment.  Our women felt this had changed the focus from their cardiac problem to a more positive focus on their pregnancy, birth and preparation for parenthood.

We have also improved and expanded our high dependency facilities on the maternity unit, which enables some women who require critical care around the time of delivery, to be looked after on the unit, instead of being transferred to the Intensive Care Unit.  This prevents mums being separated from their newborn and allows for immediate bonding and breastfeeding. 

We also help care for women from other centres by providing support and advice.  This allows us to have a positive impact on many more pregnancies, whilst ensuring we can bring women with the most complex cases to our service to receive the specialist care they need. 

  

NOTES:

  • A recent audit showed that 100% of women seen by the Joint Obstetric/Cardiac service had an individualised care plan for delivery completed.
  • Women with such complex disease in pregnancy always require cardiology, obstetric and midwifery input. The cardiac technicians, obstetric anaesthetists, ultrasonographers and fetal medicine team have an input into the care of most women. Some women also require input from cardiac surgeons, radiologists, gynaecologists, cardiac anaesthetists, theatre staff, haematologists, other physicians, neonatologists and neonatal nurses, intensive care staff (medical and nursing), perfusionists and physiotherapists.
  • Following the move of the clinic from the main out-patients department to the antenatal clinic setting a survey of the women attending found that all women felt this had been an improvement; all valued the arrangements where all investigations were performed at the one visit, and clinicians worked together within the one clinic; they commended the approach of staff, and felt confident that they were receiving high quality care.  
  • The Joint Obstetric/Cardiac service serves women from Greater Manchester, Lancashire, Cumbria, North Cheshire, Mersey and North Wales - this includes 61 English constituencies and 6 Welsh constituencies.
  • Our service has received national and international recognition as an example of good practice, with invitations for members of the team to facilitate workshops at the Royal College of Obstetricians and Gynaecologists and to present at national and international conferences such as Cardiac Problems in Pregnancy in Valencia (2010), and High Risk Obstetrics in Calicut, India (2010).
  • The team have engaged proactively in training and education by welcoming undergraduate or postgraduates from many disciplines to attend the clinic. Members of the team have volunteered to speak at Local, Regional, National and International meetings about heart disease in pregnancy. Members of the team have also organised postgraduate meetings including heart disease in pregnancy on the programme. Furthermore they have facilitated workshops and given presentations at meetings of User groups and Patient Support Groups eg British Heart Foundation, Turner's society, Children's Heart Association. These activities help raise patients' and clinicians' awareness of the role of the Joint Obstetric /Cardiac clinic.