Obstetric Care Plan
A specific obstetric care plan needs to be devised for the MH susceptible parturient or the parturient with a MH susceptible partner. This is because the inhalational anaesthetics and suxamethonium are the most commonly used anaesthetic drugs for the obstetric patient requiring general anaesthesia. Development of the obstetric care plan should be instigated by contacting the relevant obstetric anaesthetist following the antenatal booking clinic visit when the MH history is elicited.
The aim of the obstetric care plan is to minimise the risk of requiring emergency general anaesthesia. Our advice is that consideration should be given to establishing epidural analgesia early in the course of labour. During the course of labour there should be regular communication between the duty Labour Ward anaesthetist and midwives in order to monitor the progress of labour. The duty anaesthetist should be called at the earliest opportunity should the midwife consider operative obstetric intervention to be a possibility. It is our experience that a well functioning epidural can be topped up to achieve surgical anaesthesia as rapidly as delivery of an emergency general anaesthetic.