[Establishment and one-year evaluation of an internal medicine consultation in a maternity]

Sante Publique. 2018 September-October;30(5):671-677. doi: 10.3917/spub.186.0671.
[Article in French]

Abstract

Objective: In the obstetric medicine movement and in response to requests for appointments in internal medicine by obstetricians and midwives, we created an internal medicine consultation within the maternity ward of our General Hospital, and provide feedback after 1 year.

Methods: This retrospective descriptive study took place at the Robert Ballanger Intercommunal Hospital Center in Aulnay-sous-Bois in Seine-Saint-Denis (France) between 3rd March 2016 and 9th March 2017, the first year of the internal medicine consultation, one afternoon every 15 days, in the maternity level 2b.

Results: Out of 121 appointments, 93 consultations were conducted for 63 patients. The main reasons were: thromboembolism (n=2), placental vascular disease (n=14), anemia (n=9), HIV infection (n=8), fetal deaths in utero (n=6), thrombocytopenia (n=6) and autoimmune biological abnormalities (n=3). Although none etiology was found for 16 patients (including 11 seen for placental vascular disease), a diagnosis was made in 75% of cases with a suitable therapeutic attitude. The diagnoses were varied: antiphospholipid syndrom, hypertension, but also discovery of a primary biliary cirrhosis, of a veritable pregnancy-induced immune thrombocytopenia induced by the pregnancy and of a lymphoma-associated on anemia.

Conclusions: This consultation provides satisfaction in terms of interdisciplinary organization and collaboration. It appears useful to patients, leading to prevention advice, various diagnoses and sometimes long-term follow-up.

MeSH terms

  • Female
  • France
  • Health Services Research
  • Humans
  • Internal Medicine / organization & administration*
  • Maternal Health Services / organization & administration*
  • Pregnancy
  • Referral and Consultation / organization & administration*
  • Retrospective Studies