Indications for antenatal anaesthetic referral

 Guidelines for the Antenatal Referral of women to the Obstetric Anaesthetist

 Referrals can be sent through Badgernet or emailed directly to anaesthetic team.

Contact: anaestheticobstetric.referrals@borders.scot.nhs.uk

Urgent referrals – contact Obstetric Anaesthetist of the week (IH, VM or SA) via Anaesthetic Secretary Ms Marie Dodds, (01896) 826322, Extension 26322

Obstetric

·       Major placenta praevia with previous caesarean section

·       All other Major anterior placenta praevia

Neurological

·       Poorly controlled epilepsy

·       Myasthenia Gravis

·       Spina bifida

·       Multiple sclerosis

·       Past history of trauma, tumours, stroke

Cardiovascular

·       All cardiac conditions except murmurs with normal echocardiogram *

Respiratory Disease

·       Any severe disease

Anaesthetic

·       Previous difficulties (i.e. failed intubation or regional analgesia, dural tap, pain during caesarean section)

·       Presence of risk factors (e.g. neck injury)

·       Drug reactions

·       Severe reactions on previous exposure

Haematological

·       Clotting/platelet problems

·       Sickle disease and variants

·       Patients who are Jehovah’s Witnesses *

Musculoskeletal

·       Back problems (including thoracic)

·       Severe neck or joint problems

·       Spina bifida

Endocrine

·       Severe disease (e.g. diabetics with neuropathy/renal impairment, phaeochromocytoma)

Miscellaneous

·       Morbid obesity (BMI of over 40)

·       Severe anxiety

·       Needle phobia *

·       Any other concerns by midwifery or medical staff that may warrant an anaesthetic opinion

* Indicates an early referral is advised