High-Risk Consult Multidisciplinary Team in a Tertiary Maternity Unit: Changing Prevalence of Cases

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics
• Neonatology

Background:

• High-risk pregnancies necessitate multidisciplinary expertise.
• The High-Risk Consult (HRC) model integrates specialists for complex cases.
• Limited data exists on the prevalence and patterns within HRC services.

Purpose of the Study:

• To characterize high-risk antenatal cases managed by an HRC.
• To compare the prevalence of these conditions across two distinct time periods.

Main Methods:

• Retrospective observational study at a tertiary center (KKH, Singapore).
• Analysis of HRC cases from two epochs: 1994-2003 and 2008-2021.

Main Results:

• The proportion of high-risk cases remained stable at ~1.5% of deliveries.
• Significant shifts observed: decreased incidence of preterm rupture of membranes, preeclampsia, and preterm labor.
• Marked increase in the prevalence of fetal anomalies.

Conclusions:

• The composition of high-risk pregnancies managed by HRC has evolved.
• Findings inform resource allocation and service planning in tertiary maternity units.
• Multidisciplinary care priorities are changing in obstetrics.