[Regionalization of obstetric services and anaesthetic workload in a tertiary level perinatal unit]

Abstract

Objective: Evaluation of anaesthetic workload associated with care of high-risk pregnant women (i.e. patients transferred to a referral perinatal center).

Study design: A case-control prospective study.

Methods: During a three-month period, 63 women with in-utero transfer and their control counterparts (63 normal pregnancies) were prospectively followed until discharge.

Results: At inclusion, high-risk patients (n = 63) were more frequently scored ASA 2 or more (21 vs 0%, p < 0.05). ASA score had increased at delivery in 8% of high-risk women and in none of controls. ICU admission (4 vs none), Caesarean delivery (57 vs 11%), preanaesthetic visit at night (41 vs 0%) and general anaesthesia (27 % versus none) were all more frequent in high-risk parturients (p < 0.05).

Conclusion: Comparison of the workload associated with high-risk patients and normal pregnant women confirms the need for increased anaesthetic staffing in referral perinatal centers and provides a basis for better understanding the distribution of anaesthetic requirements in each perinatal network.