Review of a high-risk obstetric anesthesia antepartum consult clinic

摘要

To the Editor,The co-management of high-risk pregnancies for women with significant medical comorbidities is becoming an increasingly prominent responsibility for anesthesiologists. The most recent report by the Centre for Maternal and Child Enquiries suggests that there is a lack of appropriate referral for high-risk patients and that many of the women who died from preexisting medical conditions did not receive pre-counselling or did not see the referred specialist in time. Nonetheless, there is a paucity of literature on this subject, which is not surprising given the low incidence of high-risk antenatal anesthetic clinics. A survey of practice in the United Kingdom revealed that a dedicated clinic for pre-assessment of high-risk obstetric cases existed in only 30% of obstetric units. Only one review detailing an obstetrical anesthesia assessment clinic has been published to date. A voluntary high-risk obstetrical anesthesia patient registry exists in the United Kingdom with publications focused on subspecialty cases, but denominator data are unavailable to estimate incidences of various high-risk disorders.