Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;9(4):191-196.
doi: 10.5152/eujrheum.2022.20012.

Multidisciplinary models for pregnancy care in patients with rheumatic diseases: Clinical experiences and experts opinion

Affiliations

Multidisciplinary models for pregnancy care in patients with rheumatic diseases: Clinical experiences and experts opinion

Andrea Pluma et al. Eur J Rheumatol. 2022 Oct.

Abstract

Objectives: To describe different models of multidisciplinary pregnancy care for patients with inflammatory and autoimmune rheumatic diseases, and the steps to follow concerning their implementation.

Methods: A qualitative study was conducted including: (1) a comprehensive literature search in PUBMED focused on multidisciplinary care models; (2) structured interviews with seven rheumatologists from multidisciplinary pregnancy clinics for patients with inflammatory and autoimmune rheumatic diseases. Data were collected related to the hospitals, medical departments, populations cared for, and multidisciplinary care models (type, material, and human resources, professional requirements, objectives, referral criteria, agendas, protocols, responsibilities, decision-making, research and educational activities, multidisciplinary clinical sessions, initiation/start, planning, advantages/disadvantages, and barriers/facilitators for implementation); (3) a nominal meeting group in which the results of searches and interviews were analyzed and the recommendations for the implementation of the multidisciplinary care models defined.

Results: We analyzed seven models of multidisciplinary care in pregnancy, implemented 3-10 years ago, which can all be summarized by two different subtypes: parallel (patients are assessed the same day in the involved medical services) and preferential (patients are assessed on different days in the involved medical services) circuits. The implementation of a specific model results rather from an adaptation to the hospital's and professionals' circumstances. Correct planning and good harmony among professionals are key points to implementing a model.

Conclusion: Different multidisciplinary care models have been implemented for patients with inflammatory and autoimmune rheumatic diseases during pregnancy. They pretend to improve care, system efficiency, and collaboration among specialists and should be carefully implemented.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Project steps.
Figure 2.
Figure 2.
Features of the parallel care model.
Figure 3.
Figure 3.
Features of the preferential care model.
Figure 4.
Figure 4.
Structure, scope, and referral criteria of the multidisciplinary care for patients with rheumatic inflammatory diseases.

References

    1. Ogdie A, Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am. 2015;41(4):545-568. - PMC - PubMed
    1. Mirabelli G, Cannarile F, Bruni C, Vagelli R, De Luca R, Carli L. One year in review 2015: Systemic lupus erythematosus. Clin Exp Rheumatol. 2015;33(3):414-425. - PubMed
    1. Ostensen M, Clowse M.. Pathogenesis of pregnancy complications in systemic lupus erythematosus. Curr Opin Rheumatol. 2013;25(5):591-596. - PubMed
    1. Perricone C, de Carolis C, Perricone R. Pregnancy and autoimmunity: A common problem. Best Pract Res Clin Rheumatol. 2012;26(1):47-60. - PubMed
    1. Clowse ME. Managing contraception and pregnancy in the rheumatologic diseases. Best Pract Res Clin Rheumatol. 2010;24(3):373-385. - PubMed