Obstetric anaesthetists are important in labour care

EDITOR—We wish to rectify an important omission in the ABC of Labour Care—that is, the role of the obstetric anaesthetist on the labour ward. The report on confidential inquiries into maternal deaths in the United Kingdom in 1994-6 highlights the importance of multidisciplinary care for pregnant women and establishes lack of teamwork as an identifiable cause of substandard care.1

The leading causes of maternal death in the United Kingdom are thromboembolism, pregnancy induced hypertension, amniotic fluid embolism, and haemorrhage. Publications from the Royal College of Obstetricians and Gynaecologists emphasise the need for early involvement of anaesthetists in the management of major haemorrhage,2 and an anaesthetist has an essential role in managing other life threatening obstetric emergencies. Many sick mothers are now admitted to intensive or high dependency care units. Early involvement of the anaesthetist on the labour ward facilitates earlier transfer of sick mothers; delay in transfer has been identified as a cause of substandard care in …