Objective To evaluate the clinical profile of inpatient obstetric referrals to the neurology services and to determine the yield of neuroimaging studies in these patients.
Methods A retrospective cross-sectional study design was used to collect the data. The study examined all inpatient obstetric referrals to the neurology services at a busy London hospital over a year. The hospital has a large obstetric unit with more than 5700 births per annum.
Results There were a total of 314 inpatient referrals to the neurology department and of these, there were 25 obstetric referrals (8%). These included 14 patients with headaches (13 were diagnosed as migraine by the attending neurologist), four with seizures, six with post-epidural lower limb symptoms and one with postpartum delirium. Of the 25 referrals, 15 (60%) had neuroimaging performed acutely and out of these, 10 were unremarkable and five had incidental abnormalities, which were not felt to account for the patient's symptoms.
Conclusion A fair proportion of inpatient referrals to the neurology services were from the obstetric unit. Headache was the commonest reason for referral and of these, nearly all were migraines. A large proportion of the referrals had neuroimaging performed acutely and the majority of these were unremarkable. This suggests a need for better guidance on the judicious use of neuroimaging in obstetric patients presenting with neurological symptoms, in particular headaches.
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