Obstetric Anaesthesia Annual Scientific Meeting 2024

A Novel Postnatal Outpatient Follow-Up Pathway in Obstetric Anaesthesia

Desmond Wilson, Gauri Dashputre, Lorien Branfield

Who is traditionally offered Obstetric Anaesthesia follow-up?

•Day 1 inpatient follow-up is well established in Obstetric Anaesthesia

•Until now, outpatient follow-up was largely reserved for specific physical complaints, such as post-dural puncture headache

•Patients did not have access to a formal outpatient follow-up pathway

Why has outpatient Obstetric Anaesthesia follow-up changed?

The Ockenden report included actions applicable to all maternity services in England, in addition to those specific to the trust. One of the report’s directives on Obstetric Anaesthesia states that ‘Anaesthetists must be proactive in recognising situations where an explanation of events and an opportunity for questions may improve a woman’s overall experience and reduce the risk of long-term psychological consequence’

When are patients now referred?

The key change in philosophy is that patients are now given the choice to see an Anaesthetist. Other criteria:

•The healthcare professional thinks the patient would benefit from follow-up

•Significant failure of labour analgesia

•Intraoperative pain, with conversion from regional to general anaesthesia

•Admission to Critical Care

•Accidental awareness under general anaesthesia

•Post-dural puncture headache requiring a blood patch

•Neurological injury following a spinal or epidural

What changes have been made?

Referrals:

•Any healthcare professional can make a referral using the new referral criteria

•During the day 1 inpatient postnatal visit, Anaesthetists now proactively seek patients who may benefit from the postnatal clinic

A new type of clinic!

•Traditionally, postnatal reviews are held by midwives and obstetricians. Our new anaesthesia clinic provides a specialist review aimed at addressing specific concerns; this can avoid long-term psychological harm.

•45 minute consultant led appointments

•Held at a location distant from the hospital; avoiding the risk of triggering distressing memories/ emotions

•One appointment. Patients can be referred to relevant specialist services (e.g. counselling), as required.

How is the new service perceived by patients?

•6 clinics held so far

•Patient satisfaction is high; attendees appreciate the:

- Opportunity & time to debrief with a consultant Anaesthetist; providing information and improved understanding of events

- Opportunity to obtain appropriate subsequent referrals

Obstetric Anaesthesia Annual Scientific Meeting 2024

A Novel Postnatal Outpatient Follow-Up Pathway in Obstetric Anaesthesia

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