Irish Medicines in Pregnancy Service plans to expand nationally

The Irish Medicines in Pregnancy Service (IMPS), developed at the Rotunda Hospital, Dublin, “remains confident” funding will be allocated to develop the service nationally.

“We remain in continual engagement with our primary funders, RCSI Hospitals Group/HSE and the National Women and Infants Health Programme, to source recurring funding to sustain and develop IMPS services,” a spokesperson informed the Medical Independent. The IMPS is a multidisciplinary service involving collaboration between specialist healthcare professionals in obstetrics, maternal-foetal medicine, and pharmacy. IMPS aims to support safe and effective use of medicines before, during, and after pregnancy. The IMPS leadership team was established through support from the Rotunda board’s own funds.

A key component of the IMPS is an enquiry-answering service providing “objective, evidence-based information” on the use of medicines before, during, and after pregnancy to support effective risk communication and empower informed decision-making. As the scope of IMPS services is currently focused on patients attending the Rotunda, the majority of queries to date have originated from staff at the hospital (84 per cent), with most coming from consultants (37 per cent) and NCHDs (16 per cent), followed by pharmacists (24 per cent) and midwives (7 per cent). One-third of queries originated from outside the Rotunda, including from GPs (6 per cent), other hospitals (7 per cent) and members of the public (3 per cent).

Most queries related to pregnancy (53 per cent) and breastfeeding (28 per cent). However, queries also related to preconception counselling (4 per cent), termination of pregnancy or unintentional medication exposure in early pregnancy (6 per cent), and other issues including postpartum, gynaecology and miscellaneous queries (9 per cent).
During the pandemic, the IMPS contributed to the development of national guidelines on the management of Covid-19 in pregnant women and education sessions for healthcare professionals. In addition, the IMPS, in collaboration with the RCPI Institute of Obstetricians and Gynaecologists, advocated for informed decision-making with respect to Covid-19 vaccination in pregnant and breastfeeding women.

“Building on our experience with supporting and empowering informed decision-making on Covid-19 vaccines in pregnancy, our focus will expand to other medications and medical conditions including other vaccines, anti-epileptics, psychotropic medications, and medications used to treat autoimmune and inflammatory conditions. We aim to achieve this through the strategic priorities of information provision, multidisciplinary collaboration, advocacy, education, and research,” added its spokesperson.