Maternal Medicine

QMC maternal medicine team image City maternal medicine team Our service is run across both City Hospital and QMC sites. Our maternity team work closely together and will support you in your choice of place of birth. However, you may be advised to give birth at a particular location depending on where the relevant associated specialists are based.

If you have a medical condition seek advice from the professional who currently cares for you (either GP or hospital consultant) about pregnancy. If possible ask for a referral to our service before you become pregnant.

If you become pregnant prior to having this discussion, please continue any medication (unless you have been told otherwise by a health professional) and seek advice from your GP or consultant as soon as possible.

You can access information about the effects of medication in pregnancy here.

Cardiac Disease

Women with cardiac disease who are pregnant or considering pregnancy will be invited to attend our specialist obstetric cardiac clinic.

This clinic is supported by a multi-disciplinary team meeting (including cardiologists, obstetricians, anaesthetists, and when necessary haematologists and neonatologists) where all women with heart disease are discussed to ensure optimal care.

Clinics occur at City Hospital on Tuesday afternoons. The clinic team is led by Dr Gemma Malin and Dr Suzanne Wallace, Consultant Obstetricians.

Care is individualised both during pregnancy and birth, taking into consideration pregnancy and cardiac factors, and your preferences. In most cases a vaginal birth is recommended. There are very few heart conditions in which caesarean birth is considered safer.

Cardiac Info graphic image

Diabetes in pregnancy

Specialist clinics focusing on women with diabetes in pregnancy (Type 1, Type 2 or gestational diabetes) are conducted at both Nottingham City Hospital and QMC. To ensure the best possible care women are seen regularly throughout the pregnancy and given advice and guidance to minimise the risks for both mother and baby.

The multi-disciplinary team includes consultant obstetricians, endocrinologists, diabetes specialist nurses and midwives and dieticians.

For further information on planning a pregnancy when you have diabetes see the Diabetes UK website.

The service submits data on care of women with Type 1 or Type 2 Diabetes to the National Pregnancy in Diabetes audit to compare the outcomes of women in our clinic to those across the country. See our Audit Summary here.

Diabetes team image

Epilepsy and Seizure Disorders

We offer specialist clinics for women with epilepsy at both City Hospital and QMC. These enable women who are pregnant or considering pregnancy to have care from an epilepsy specialist nurse and obstetrician with support from a consultant neurologist.

The QMC Clinic takes place on Tuesday mornings with Dr Dipa Kapoor, Consultant Obstetrician and Angie Jones, Epilepsy Specialist Nurse. 

The City Hospital Clinic takes place on Thursday afternoons with Dr Suzanne Wallace, Consultant Obstetrician and Angie Jones, Epilepsy Specialist Nurse. 

Women with other seizure disorders (including non-epileptic attack disorder) are also seen within these clinics.

Before your appointment: 

  • take high dose (5mg) folic acid daily, ideally starting before you become pregnant (this needs to be prescribed by a doctor)

  • do not stop your anti-epileptic medication

For more information please see our Epilepsy and Pregnancy video.

Endocrine

Our service is run jointly by consultant obstetricians and endocrinologists at each campus. We see women who have thyroid disease and other endocrine problems including Addison's disease. 

 

Hypothyroid

If you have an underactive thyroid (which has never been overactive), ask your GP to check your thyroid function when you find out you are pregnant. You may need an increase in the dose of your thyroxine medication during pregnancy to optimise your levels.

If necessary, your GP can refer you to one of our clinics.

 

Hyperthyroid

If you have, or have previously had, an overactive thyroid, you will be offered an appointment at one of our clinics. If you are on treatment to control your thyroid, please discuss with your endocrine consultant if you are planning a pregnancy for advice.

If you discover you are pregnant, please inform your GP or consultant as soon as possible and ask for an early referral to our service. 

Haematology

We offer haematology clinics at both City Hospital and QMC. 

There are a variety of women that are suitable for this clinic, for example:

  • women with sickling disorders or thalassaemia
  • women who have been affected by lymphoma or leukaemia
  • women who have low or high platelets
  • women who have had a thrombosis

There are many other conditions where women affected would benefit from the clinic, and these will be assessed individually at your first appointment with your midwife.

Hypertension

You may be referred to this service if:

You have pre-existing high blood pressure and become pregnant

  • If you are planning a pregnancy, or find out that you are pregnant, speak to the GP or hospital consultant who  prescribes the medication you take to control your blood pressure as soon as possible. They will ensure that you are on a medicine that is safe for pregnancy.
  • We recommend that you take aspirin 75mg once a day from 12 weeks of pregnancy to reduce the risk of developing pre-eclampsia. Your midwife or GP should arrange a prescription.

You have developed hypertension in pregnancy

  • It may be necessary to arrange further tests or follow up to determine the cause of the high blood pressure

  • Having high blood pressure in pregnancy, particularly pre-eclampsia that begins before 34 weeks, means that you have a higher chance of developing high blood pressure in later life. We will advise you on further investigations, and lifestyle advice, to help you reduce the risk.

The maternal clinic is held on Tuesday morning at QMC with Dr Clare Gibbin, Dr Jane Rutherford, Dr Dipa Kapoor and Dr Annette Freyer. The City Hospital clinic is held on a Thursday afternoon with Dr Lucy Kean

Lucy Kean Hypertension image

Kidney Disease

Women with kidney disease who are pregnant or considering pregnancy should be invited to attend our specialist obstetric renal clinic.

This clinic is at City Hospital on Thursday afternoon and enables women to seek advice from a renal physician and specialist obstetrician at the same time. 

The team includes Dr Suzanne Wallace, Consultant Obstetrician, Dr Alastair Ferraro, Consultant Nephrologist and Dr Matt Hall, Consultant Nephrologist.

See our leaflet for more information

Renal team image