Antenatal anaesthetic assessment of the pregnant woman

The number of pregnant women with significant pre-existing disease is thought to be increasing. Appropriate early referral of these women to an anaesthetist for assessment allows for the identification of problems or potential problems and formulation of a management plan for the pregnancy, delivery and puerperium. The options for analgesia in labour and/or anaesthesia for operative delivery, including the risks and benefits, can be discussed calmly in the clinic setting, and the patient's views or concerns sought. Any special requirements (e.g. latex-free equipment, extra staff, ICU bed) can also be planned for accordingly. We review the categories of cases that would benefit from antenatal referral to an anaesthetist and discuss possible strategies for the setting up of a designated antenatal anaesthetic assessment service.