AB1230 DISEASE ACTIVITY OF RHEUMATIC DISEASES DURING PREGNANCY COMPARED TO REPORTED DISEASE ACTIVITYPRIOR TO PREGNANCY AS OBTAINED FROM AN ANTENATAL RHEUMATOLOGY OBSTETRIC COMBINED CLINIC AND MODE OF DELIVERY

Background A Rheumatology Obstetrics Care Clinic (ROCC) was established at our ante natal unit to ensure specialist care for women with complex rheumatological conditions (RC). Although patients are often counselled about a likely improvement in their RC in pregnancy, this was not the experience of our patients’ group from the ROCC. Objectives To obtain pregnant women with RC disease activity (DA) scores during and prior to pregnancy. To assess modes of delivery (MoD) and compare them to our general non arthritic population MoD. Methods Patients suffering from any RC attending a dedicated highly specialized antenatal ROCC were given 2 separate 10cm visual analogue scales (VAS) asking them to grade on each one of them the current ( at ROCC) DA and their perceived DA prior to pregnancy. Electronic delivery records were used to collect obstetric and foetal outcomes. SPSS was used for statistical analysis and chi square to assess the difference between the 2 groups. Results Data from 54 patients who attended the ROCC included of whom 50 were analyzed. At the time of presentation mean age ( ±sd) was 33.4 years (± 4.29) range 22-43y while age of disease presentation was 25.5 ( ±8.06). The weeks (w) of pregnancy during ROCC were (mean) 22.2 (±8.6) range 8-37 w. ESR (mean) was 27 mmHg (± 21.7), CRP 13.6 mg/L( ±14.18). DA at presentation on VAS was 4.24cm (± 2.8) and prior to pregnancy was 4.24cm (± 3.07). The recorded diseases were: Connective Tissue Diseases (CTD)=n= 18 (33.3%) Spondylo-arthropathies (SpA) n=16 (29.6%),Rheumatoid Arthritis (RA)n =9 (16.7%), Antiphospholipid Syndrome (APS) n=7 (13%) and other n=4 (7%) The group of other (Still’s disease 1, Juvenile idiopathic arthritis 1, fibromyalgia 1 and knee pain 1) were excluded from analysis. Looking at the disease groups RA and SpA patients’ showed a reduction in the reported DA during pregnancy while CTDs and APS showed an increase; neither was statistically significant (ss). Delivery outcomes available on 35 patients revealed that 25 of 35 RC patients (71.4%) achieved a vaginal delivery with 5 of 25 (20%) requiring assisted delivery and 10 of 35 (28.5%) had a Caesarean section (CS). These percentages are comparable with non arthritic patients. Conclusion In our group of pregnant patients with RC the overall DA is the same during pregnancy and prior to conception. DA according to diseases showed that women with RA and SpA had a reduction in DA and those with CTDs and APS had an increase. The MoD showed similar percentages in vaginal and CS delivery rates as per healthy population suggesting that MoD is not impacted by RC. Acknowledgement Patients for filling the ROCC questionnaire Disclosure of Interests None declared