[High-risk obstetrics in tertiary centres: anaesthetist, hybrid operating suite and obstetric critical care unit]

The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome. The role of a dedicated obstetric anaesthetist in this multidisciplinary team is essential. In contrast with other Western countries, in the Netherlands this has so far been underestimated. Obstetric anaesthetists should also be part of multidisciplinary obstetric care in high-risk patients during pregnancy, thus optimalising conditions for successful delivery and maternal and foetal outcome.