Specialised resources and recommendations to monitor maternal health and to ensure healthy pregnancies outcomes Image Introduction At NHS Lothian and University of Edinburgh we offer a specialist service for pregnant women with a raised Body Mass Index (BMI) and for those with a history of Bariatric/Gastric Surgery irrespective of BMI. In 2008, Tommy’s funded a specialist clinic at the Royal Infirmary of Edinburgh, to help women who are significantly overweight to have a safe and healthy pregnancy. Our specialist service includes a Metabolic Antenatal Clinic based at the Simpson Centre for Reproductive Health at the Royal Infirmary of Edinburgh, with follow up care performed at both St John’s Hospital at Livingston and the Royal Infirmary of Edinburgh. Why have I been referred to the Metabolic Antenatal Clinic? You might be referred to the Metabolic Antenatal Clinic by your midwife if you have one or more risk factors. These risk factors include: Body Mass Index - BMI greater than 40 (Body Mass Index is a relationship between your height and your weight) History of Bariatric or Gastric Surgery What does the Metabolic Antenatal Clinic do? We provide an in-depth first visit consultation with the multi-disciplinary team at the Metabolic Antenatal Clinic. Your visits will include review by a consultant obstetrician, diabetologist (if required), dietitian, anaesthetist and midwife. The Metabolic Antenatal Clinic runs every Tuesday afternoon at the Simpson’s Centre for Reproductive Health within the Outpatients Department. At your first visit we will look at your family, medical and pregnancy history. We may also conduct some additional tests where appropriate. Your first appointment may take more than an hour and you will have an individualised care plan set at this appointment. The Metabolic Antenatal Clinic (metabolicantenatal@nhslothian.scot.nhs.uk) offers: Patient-centred antenatal care and support Management of Diabetes and other medical conditions that might affect you or your pregnancy where we will liaise with other specialities Preconception counselling for women Postnatal counselling Participation in research studies and clinical trials of new treatments which is voluntary and may be ongoing within the clinic How often do I have to come to the Clinic? One of our team will discuss this with you at your first visit and we will make an individualised appointment schedule with shared care with your community midwife. For women without diabetes your 1st visit will be around 14 weeks. Once your pregnancy reaches 36 weeks’ gestation we may discharge you from the metabolic clinic to the care of your midwife if all is well but this will depend on individual circumstances and we may continue to monitor you beyond 36 weeks at the Metabolic Antenatal Clinic if required. For women who have existing diabetes or develop Gestational Diabetes Mellitus (GDM – diabetes in pregnancy) we will aim to see you sooner for your first visit and you will need to be seen more frequently (2-4 weekly). We also offer ‘virtual’ appointments where your blood sugar levels can be reviewed remotely so that you do not need to attend a hospital appointment. What tests will I be offered? Your care will be individualised and we may offer you all or some of the following tests. Tests that may be offered are: Urinalysis Blood Pressure screening Weight on our specialist scales Blood tests – with certain conditions we may take additional bloods but usually your routine antenatal bloods taken by your community midwife are all that is required Screening for Gestational Diabetes – Your Community Midwife will arrange for you to have a fasting Blood Glucose blood test between 16-18 weeks and an Oral Glucose Tolerance Test between 24-28 weeks of pregnancy. If GDM is diagnosed we will arrange a GDM education group session at Royal Infirmary of Edinburgh. Growth scans Do the tests have any risks? All of the tests are safe for you and your baby. Do I have to come to the clinic? No, it is up to you whether to come to this clinic. You should continue to have regular antenatal appointments with your community midwife. If you have diabetes or are diagnosed with diabetes during pregnancy it is important that you attend a specialist Antenatal Diabetic Clinic. Research We also conduct research studies within the clinic which you may wish to take part in. We conduct research to improve the care that we provide. We will explain any research clearly before asking you to take part and we will always ask for your written consent. You do not have to take part and your care will not be affected by your decision. Meet the Team Information for Patients Having an electrocardiogram (ECG) done Why do I need to see an anaesthetist during my pregnancy? Being overweight during pregnancy and after birth Weight management in pregnancy Physical activity and pregnancy How to contact us If you think you might benefit from being seen in the Metabolic Antenatal Clinic please discuss referral with your community midwife If you would like to speak to a member of the team please call 0131 242 2480 (answer phone service – please leave your details and we will call you back). Alternatively you can email metabolicantenatal@nhslothian.scot.nhs.uk with your contact details and we will phone you back (due to concerns about the security of certain personal email addresses we are not able to email you). The clinic runs every Tuesday afternoon 1pm to 4pm at Simpson Centre for Reproductive Health, Outpatients Department, Royal Infirmary of Edinburgh. Can you help? Have you experienced obesity in pregnancy? Do you want to help shape research and care for women and families at risk of pregnancy complications? If you would like to find out more or actively become involved in the Pregnancy Advisory Group, please contact: Carol Porteous, Patient Public Involvement Advisor (Education Core) Edinburgh Clinical Research Facility, Wellcome Trust CRF, Western General Hospital, Edinburgh EH4 2XU www.edinburghcrf.ed.ac.uk Twitter:@carol_porteous Email: carol.porteous@ed.ac.uk This article was published on 2024-09-10
