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Consultation in family practice obstetrics
A J Reid1, J C Carroll, J Ruderman
1Department of Family and Community Medicine, University of Toronto.
Purpose:
To examine the types of non-low-risk obstetric patients managed by family physicians in urban teaching hospitals, and to determine indications for consultation for women at low risk when labour began.
Method:
Retrospective chart review for all patients delivered by family physicians in three downtown Toronto teaching hospitals during 1 year.
Results:
Of 1710 cases, 595 (34.8%) were classified as non-low risk, with the main indications being postdates (> 42 weeks) (19.9%); pregnancy-induced hypertension (19.3%); and premature labour (< 37 weeks) (14.8%). Of the 1115 low-risk patients, 363 (32.6%) had an intrapartum consultation, usually for failure to progress (50.1%) or fetal distress (12.7%). More than 80% of intrapartum consultations were associated with induction and augmentation of labour.
Conclusion:
Family physicians can continue to care for many non-low-risk women, usually with the help of obstetricians. Consultations were obtained for many women at low risk. We need to reevaluate whether some mandatory consultations are necessary in family practice obstetrics.