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94 Maternity and Obstetrics 2020 | NMH Annual Rep t T here is a weekly multidisciplinary clinic for women with medical disorders led by Prof Fionnuala McAuliffe, Prof Mary Higgins, Dr Siobhan Corcoran in conjunction with Dr Karen Murphy, Consultant Haematologist and clinic midwives Ms Caroline Brophy, Ms Annabel Murphy, Ms Celine O'Brien and Ms Jacinta Byrne (haematology midwife). Ms. Victoire Hurley, drug liaison nurse, advises on women with drug addiction. There is a monthly combined obstetric – anaesthetic review of patients at the clinic with Consultant Anaesthetists Dr Roger McMorrow, Dr Ola Rosaeg, Dr Siobhan McGuinness and their team. Pharmacy provides advice on the safety of maternal medications during pregnancy and breastfeeding with weekly attendance from Ms Anne Clohessy. Specialist Services Rheumatology: in 2017 we established a monthly Reproductive Rheumatology Health Service the ROSE clinic. Prof Doug Veale, Dr Kieran Murray and Dr Aine Gorman (SpR) and Ms Louise Moore attend and women are seen for pre-pregnancy counselling and for pregnancy management. Outputs from the clinic have formed the basis for Dr Kieran Murray's PhD and two clinical research papers from this clinic were published in 2019 and 2020. Our unique care pathway has been presented at national and international meetings. Hepatology: Prof Aiden McCormick attends on a monthly basis for a joint hepatology clinic Gasteroenterology: In 2018 we established a joint gastroenterology obstetric service. Dr Juliette Sheridan and her team attend bi-monthly where we manage pregnant women with inflammatory bowel disease. Epilepsy: There is a fortnightly clinic to review pregnant women with epilepsy run by Ms Sinead Murphy, specialist epilepsy midwife funded by Brainwave. Each woman is seen at least three times during the antenatal period and receive a postnatal telemedicine check. All women receive written information regarding their medication, and are invited to a newly established women with epilepsy private facebook group. Cardiology: Dr John Erwin cardiology at St Vincent's University Hospital reviews patients at a monthly joint obstetric clinic at SVUH with one of our team in attendance. Obstetric Haematology Service: this comprises of 2 Consultant Haematologists Dr Karen Murphy and Dr Joan Fitzgerald, a 0.5 WTE Haematology Registrar and the haematology midwife Ms Jacinta Byrne. There is a weekly Haematology clinic shared with Maternal Medicine colleagues which provides care for women with high risk thrombotic and bleeding problems during their pregnancies. This blended team ensures provision of high quality care for this complex group of patients during pregnancy. 2020 was uniquely challenging for all areas of medicine but the long established nature of the Obstetric Haematology service in NMH allowed for modifications in how the service worked robustly for periods of time when the Haematologists were off site and also allowed for swift development of new guidance with respect to COVID-19 and thrombotic risk. In addition to the numbers recorded below Jacinta Byrne reviewed 148 women with gestational thrombocytopenia, 323 with family history of venous thromboembolism and reviewed 2229 results in the virtual anaemia clinic. Maternal Medicine Midwife Clinic In 2020 Celine O'Brien saw 106 women through the maternal medicine midwife clinic which is a service for women in conjunction with the maternal medicine clinic to review women with stable disease. This accounted for approximately 16% of all maternal medicine antenatal visits and gives women access to midwifery care. The weekly maternal medicine multi-disciplinary team meeting (organised by Dr Niamh Keating and Ms. Celine O'Brien) continues to be very successful facilitating the development of multidisciplinary individualised patient plans. In 2020 there were 525 new patients seen in the maternal medical service. Some patients presented with more than one problem. The main diagnoses and indications for referral to the clinic in 2020 are recorded below (only one diagnosis per patient). In our pre-pregnancy service, we saw 48 women and their partners / family members in 2020, in addition to the numbers below. This is service is becoming increasingly popular for women with medical disorders, and we often counsel women and their partners together with the relevant physician. Maternal Medicine Service