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Five years’ experience in an anesthesiology antenatal clinic for high-risk patients

  • Daniel Shatalin EMAIL logo , Yaacov Gozal , Sorina Grisaru-Granovsky and Alexander Ioscovich
Published/Copyright: May 24, 2017
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 46 Issue 3

Abstract

Introduction:

The aim, of this study is to describe our approach and outcomes in an outpatient anesthesia/analgesia antepartum clinic among ambulatory high-risk obstetric patients.

Methods:

This was a retrospective evaluation of the activity of the anesthesiology antenatal clinic from its inception in 2010 until 2016 (a 5-year period). The clinic works in collaboration with the Department of Obstetrics and Gynecology. The catchment area of the study University Affiliated Hospital attends a multiethnic population characterized by high parity.

Results:

There were 241 referrals over the 5 years, each of whom was discharged with a consult and a delivery management plan and 228 (95%) of which were performed as planned. Mean gestational age at consultation was 34.4 weeks (range: 20–37). There were no preconceptional consultation. No limitations regarding mode of anesthesia/analgesia was considered for 47% of the referrals. Nulliparous women accounted for 50% of the referrals and 17% were in their second pregnancy. The greatest number of referrals (30%) was for musculoskeletal conditions. No maternal death encountered. The mode of delivery was vaginal in 139 (65%) women; elective cesarean section in 44 (21%) women; and emergent cesarean section in 30 (14%) women. The neonatal outcomes were unremarkable; 210 (87%) in hospital births, 97.1% had an a 5′ Apgar score of 9.

Conclusion:

Our findings reveal the need for high-risk obstetric patients consult with a dedicated obstetric anesthesiologist to devise a management plan for labor and delivery that is tailored to their comorbidity and obstetric status, to ensure an optimum outcome for mother and child.

Keywords: Antenatal consultations; antepartum clinic; high-risk; obstetric anesthesia; outpatient anesthesia clinic
Corresponding author: Daniel Shatalin, MD, Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School Ein-Karem, 12 Bayit Street, Jerusalem 91031, Israel, Tel.: +972-585511777

Acknowledgments

The authors acknowledge the assistance of Dr. Deborah Elstein in preparation of the manuscript.

  1. Author’s Statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

  5. Funding statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This study was part of the requirements for an MD Thesis by the first author, DS.

  6. Financial conflicts of interest: None of the co-authors have any conflicts of interest to declare.

References

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Received: 2017-1-14
Accepted: 2017-4-19
Published Online: 2017-5-24
Published in Print: 2018-4-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Editorial
  4. Corner of Academy
  5. Peripartum cardiomyopathy – from pathogenesis to treatment
  6. Original articles – Obstetrics
  7. Is forty the new thirty? Population based study of advanced maternal age
  8. The laboratory control of anticoagulant thromboprophylaxis during the early postpartum period after cesarean delivery
  9. Epidural analgesia at trial of labor after cesarean (TOLAC): a significant adjunct to successful vaginal birth after cesarean (VBAC)
  10. Postpartum infection in relation to maternal characteristics, obstetric interventions and complications
  11. A technological advance for 21st century obstetricians: the electronically-controlled vacuum extractor
  12. Five years’ experience in an anesthesiology antenatal clinic for high-risk patients
  13. Clinical analyses of 383 cases with maternal cardiac diseases
  14. Induction of labor in patients with an unfavorable cervix after a cesarean using an osmotic dilator versus vaginal prostaglandin
  15. The misoprostol vaginal insert compared with oral misoprostol for labor induction in term pregnancies: a pair-matched case-control study
  16. Adiponectin concentration in mid-trimester amniotic fluid varies with the α-amylase level and maternal and neonatal outcomes
  17. Placental examination in nonmacerated stillbirth versus neonatal mortality
  18. Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation: a nationwide, population-based record linkage study
  19. An observation of umbilical coiling index in a low risk population in Nigeria
https://doi.org/10.1515/jpm-2017-0016
Keywords for this article
Antenatal consultations; antepartum clinic; high-risk; obstetric anesthesia; outpatient anesthesia clinic

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Editorial
  4. Corner of Academy
  5. Peripartum cardiomyopathy – from pathogenesis to treatment
  6. Original articles – Obstetrics
  7. Is forty the new thirty? Population based study of advanced maternal age
  8. The laboratory control of anticoagulant thromboprophylaxis during the early postpartum period after cesarean delivery
  9. Epidural analgesia at trial of labor after cesarean (TOLAC): a significant adjunct to successful vaginal birth after cesarean (VBAC)
  10. Postpartum infection in relation to maternal characteristics, obstetric interventions and complications
  11. A technological advance for 21st century obstetricians: the electronically-controlled vacuum extractor
  12. Five years’ experience in an anesthesiology antenatal clinic for high-risk patients
  13. Clinical analyses of 383 cases with maternal cardiac diseases
  14. Induction of labor in patients with an unfavorable cervix after a cesarean using an osmotic dilator versus vaginal prostaglandin
  15. The misoprostol vaginal insert compared with oral misoprostol for labor induction in term pregnancies: a pair-matched case-control study
  16. Adiponectin concentration in mid-trimester amniotic fluid varies with the α-amylase level and maternal and neonatal outcomes
  17. Placental examination in nonmacerated stillbirth versus neonatal mortality
  18. Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation: a nationwide, population-based record linkage study
  19. An observation of umbilical coiling index in a low risk population in Nigeria
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