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Maternal Medicine Conference 2013

Universal screening of miscarriage patients could result in more live births says top UK-based Irish researcher - 8 March 2013

Dr Karen Breen, consultant in haemostasis and thrombosis, Guys and St Thomas’s Hospital, London, said last week at a conference in The Rotunda Hospital, Dublin that more women with recurrent miscarriages should be screened for a particular disease, antiphospholipid syndrome. Once detected, it could result in better specific treatments and improve chances of a successful pregnancy. She said that the syndrome was both under-recognised and under-diagnosed amongst miscarrying women.

In her keynote address to the Maternal Medicine Clinical Update 2013, held in the Pillar Room at the Rotunda Hospital, on 8 March, Dr Breen said that a multi-disciplinary approach to the management of pregnancy would benefit these kinds of patients enormously.

Dr Breen outlined advances in the management of antiphospholipid syndrome in pregnancy and stressed that with the ‘best treatment women can still have successful pregnancies’. Management should be carried out by a multi-disciplinary team, she stressed. Dr Breen is a TCD graduate, and completed the haematology specialist training scheme in Ireland. Three years ago, she went to Guys and St Thomas’s to conduct research and was appointed as a consultant a year ago. Her current research has a translational focus with the aim of improving clinical outcomes. In addition to antiphospholipids, she is also investigating the role of complement.

The Maternal Medicine day, which was convened by Dr Fionnuala Ni Ainle, consultant haematologist in the Rotunda and sponsored by an educational grant from LEO Pharma, was well attended with some 150 delegates listening to presentations. Dr Maeve Eogan, consultant obstetrician in the Rotunda hospital, opened the day with a talk on the management of maternal infectious diseases in pregnancy. Dr Jeremy Sargent, consultant haematologist, Our Lady of Lourdes Hospital, Drogheda, spoke about challenges in managing haematological malignancy during pregnancy while Dr Peter McKenna, clinical director and consultant obstetrician in the Rotunda, addressed the issues of cardiac disease and pregnancy.A keynote talk by Dr John Stinson, senior international medical adviser in thrombosis, LEO, Ireland, discussed the use of tinzaparin in pregnancy – real life data and practical issues.

In the afternoon, Dr Karen Murphy, consultant haematologist in the National Maternity Hospital, Holles Street, provided a haematologist’s perspective on major obstetric haemorrhage. This was followed, appositely, by an outline, by Dr Niamh Hayes, consultant anaesthetist, of the experience of the Rotunda hospital in using intraoperative cell salvage in major obstetric haemorrhage.

Dr Anne Fortune, consultant haematologist, Our Lady of Lourdes Hospital, Drogheda, discussed the prevention and management of RhD sensitisation in pregnancy while Dr Joan Fitzgerald, consultant haematologist in the Irish Blood Transfusion Service, discussed fetal and neonatal alloimmune thrombocytopenia. Dr Beatrice Nolan spoke of the management of bleeding disorders in pregnancy. Dr Sam-Coulter Smith, Master, Rotunda Hospital, closed a busy, lively and informative day with a final reflection on the need for a multi-disciplinary approach to the management of pregnancy.

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