Referrals to the high-risk anaesthetic antenatal clinic Discussion: Demand for clinic slots more than doubled in 5 years. The number of medical problems has also risen dramatically, with 44% of patients now having 2 or more problems compared to 9% 5 years ago. An increase in the number of women with a BMI>40 kg/m 2 puts additional pressure on delivery suites and elective caesarean lists as IV access, neuraxial blocks and operative delivery are more complex and time-consuming. Our unit has needed to rapidly adjust to the increasing demand and complexity of patients by adding additional clinics, training in ultrasound for neuraxial procedures, and more double time slots on elective lists for patients with high BMI or medically complex pregnancies. We anticipate that this trend will continue, with a similar picture seen in smaller centres within 5 years. References

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