Prepregnancy counselling: experience from 1,075 cases.
OBJECTIVE
To assess the activity of a prepregnancy counselling clinic in terms of investigations, counselling, treatment and subsequent pregnancy outcome.


METHODS
Review of 1,075 couples attending over a nine year period.


METHODS
University Hospital offering a tertiary referral service for fetal medicine.


METHODS
Couples referred to the clinic from a variety of sources.


METHODS
Categories of referral, value of diagnostic tests, and subsequent pregnancy outcome.


RESULTS
The main categories of referral were: previous miscarriage (44.4%); previous fetal abnormality (19.6%); chronic maternal disease (22.3%); and others (13.7%). Routine investigations produced a low yield of abnormality (1%), in contrast to investigations selected for specific reasons (12%). Subsequent pregnancy outcome, which was unaltered in either the previous miscarriage or fetal abnormality groups, did improve in the chronic maternal disease group.


CONCLUSIONS
This study does not prove the value of prepregnancy counselling. However, it does illustrate the importance of making an accurate assessment of previous problems and current health as a means of determining both maternal and fetal risks in a subsequent pregnancy, a process which seems to lead to an improved outcome within selected groups. The importance of continuity of care in all couples, especially when there has been a previous adverse pregnancy outcome is emphasized.
Cox
M
M
University Department of Midwifery, Queen Mother's Hospital, Yorkhill, Glasgow, UK.
Whittle
M J
MJ
Byrne
A
A
Kingdom
J C
JC
Ryan
G
G
D000022:Abortion, Spontaneous / Q000150:complications; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003376:Counseling; D005260:Female; D005333:Fetus / Q000002:abnormalities; D006801:Humans; D008875:Middle Aged; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012017:Referral and Consultation