New Clinic Cares for Pregnant Patients with Respiratory Conditions

New Clinic Cares for Pregnant Patients with Respiratory Conditions

The MetroHealth System's Pulmonary, Critical Care, and Sleep Division, Division of Maternal Fetal Medicine and Department of Obstetrics & Gynecology have collaborated to establish a joint clinic for pregnant patients who have asthma and other respiratory conditions.

The Obstetric Pulmonary Clinic will be open one-half day each month in the offices of Pulmonary Medicine at MetroHealth's Main Campus.

While the idea of multidisciplinary obstetric clinics is not new, this is the first one in the region focused on pulmonary conditions, said pulmonologist Andrew Lewis, DO, who leads the Obstetric Pulmonary Clinic. The need is great, particularly among MetroHealth's patient population.

Asthma, which affects as many as 8% of pregnancies in the United States, occurs in significantly higher rates among patients from disadvantaged socioeconomic backgrounds. At MetroHealth the rate is 18%.

"This program has the potential to significantly improve the health outcomes for our pregnant patients," said Daryl Thornton, MD, MPH, MetroHealth Director of Pulmonary, Critical Care and Sleep Medicine and Director of the Center for Health Equity Engagement, Education, and Research (CHEEER). "Opening the Obstetric Pulmonary Clinic is another way MetroHealth is working to achieve health equity and reversing the maternal health disparities that we know exist in communities like ours."

Dr. Lewis said patients with asthma often worry that using their inhalers during pregnancy will have an adverse effect on fetal development. This fear, based on an outdated study based on incomplete information, can lead to maternal, fetal and newborn complications.

For this reason, one of the goals of the Obstetric Pulmonary Clinic is to educate patients and providers about the importance of continuing therapy throughout pregnancy, Dr. Lewis said.

"It is safer for a patient to be on their inhalers to prevent having exacerbations and a lack of control of their asthma," Dr. Lewis said. "The risk of any potential side effects of those inhalers is far less than having uncontrolled asthma and asthma exacerbations during pregnancy, which has been linked with low fetal birth weights, preterm deliveries as well as birth defects."

Any MetroHealth provider can refer pregnant patients to the Obstetric Pulmonary Clinic, ensuring they will be seen sooner than if they had to make an appointment with a pulmonary provider.

Kelly Gibson, MD, MetroHealth Director of Maternal Fetal Medicine, hopes to launch more joint clinics with other subspecialities within the system to support the overall health of patients during pregnancy.

Dr. Gibson noted that joint clinics provide an opportunity to engage with patients during their frequent visits throughout and immediately following pregnancy to ensure they continue with their own healthcare after they deliver their babies.

"I would love to see more collaborative clinics like this," Dr. Gibson said. "As providers, we get to meet folks in other areas of the system that we may not normally work with. And it's really valuable for patients because we can expedite them getting in with these subspecialists. It's also an opportunity for us to help optimize their care and get them in the system to ensure that they have good long-term follow up care."

Patients are referred to the Obstetrics Pulmonology Clinic by their OB-GYN and are encouraged to speak with their providers for more information.