O'Brien Eileen C, Doherty Jean, Killeen Sarah Louise, Bennett Melanie, Murtagh Lillian, Curran Sinead, Murphy Suzanne, McHale Helen, Sheehy Lucille
School of Biological, Health and Sports Science, Technological University Dublin, Dublin 7, Ireland.
The National Maternity Hospital, Holles Street, Dublin 2, Ireland.
Contemp Clin Trials Commun. 2023 Nov 9;39:101227. doi: 10.1016/j.conctc.2023.101227. eCollection 2024 Jun.
Hyperemesis Gravidarum (HG) is a severe form of nausea and vomiting in pregnancy that affects 0.3-3% of women and has profound nutritional, physical and psychological consequences. Research is lacking regarding the most effective management of the condition. In response to patient feedback, a multidisciplinary HG day-case service (IRIS Clinic) was launched in 2020 at The National Maternity Hospital, Ireland. The clinic provides routine, day-case care in a comfortable space with pre-booked appointments. The MDT involves midwives, dietitians, perinatal mental health, obstetrics and pharmacy, and the nature of the clinic enables peer-to-peer support. As this clinic is the first of its kind in Ireland, we aim to assess its effectiveness and feasibility, and suggest recommendations for improvement.
This is a sequential, mixed-methods study that commenced in August 2021. The prospective arm of the study is ongoing and involves enrolling women (n = 50) who are attending the IRIS clinic. Data are collected on first admission (pre-intervention) and approximately 8 weeks' later (post-intervention) relating to symptoms of HG, well-being, food tolerances, quality of life and nutritional intake. Qualitative, semi-structured interviews will be conducted to evaluate women's experiences of attending the clinic. The retrospective arm of the study will be a chart review (n = 200) of women diagnosed with HG to describe assessments, treatments and pregnancy and birth outcomes.
The IRIS clinic has the potential to improve pregnancy outcomes and nutritional status among women with HG. If found to be effective and feasible, the model for this clinic could be replicated elsewhere.
妊娠剧吐（HG）是妊娠期恶心和呕吐的一种严重形式，影响0.3%-3%的女性，会对营养、身体和心理产生深远影响。目前缺乏关于该病最有效管理方法的研究。为回应患者反馈，爱尔兰国家妇产医院于2020年推出了多学科妊娠剧吐日间护理服务（IRIS诊所）。该诊所提供常规日间护理，环境舒适，需提前预约。多学科团队包括助产士、营养师、围产期心理健康专家、产科医生和药剂师，诊所的性质有助于提供同伴支持。由于该诊所在爱尔兰尚属首例，我们旨在评估其有效性和可行性，并提出改进建议。
这是一项于2021年8月开始的序贯性混合方法研究。该研究的前瞻性部分正在进行，包括招募到IRIS诊所就诊的女性（n = 50）。收集首次入院时（干预前）和大约8周后（干预后）有关妊娠剧吐症状、幸福感、食物耐受性、生活质量和营养摄入的数据。将进行定性的半结构式访谈，以评估女性在该诊所就诊的体验。该研究的回顾性部分将对200例被诊断为妊娠剧吐的女性进行病历审查，以描述评估、治疗以及妊娠和分娩结局。
IRIS诊所有可能改善妊娠剧吐女性的妊娠结局和营养状况。如果被证明有效且可行，该诊所的模式可在其他地方推广。
