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  1. P Dassan*,
  2. F Geranmayeh,
  3. N Davies,
  4. J Janssen,
  5. A Kennedy
  1. Chelsea and Westminster Hopsital


    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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