CONSULTATION IN FAMILY-PRACTICE OBSTETRICS

PURPOSE To examine the types of non-low-risk obstetric patients manage d by family physicians in urban teaching hospitals: and to determine i ndications for consultation for women at low risk when labour began. M ETHOD 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, w ith the main indications being postdates (> 42 weeks) (19.9%); pregnan cy-induced hypertension (19.3%); and premature labour (< 37 weeks) (14 .8%). Of the 1115 low-risk patients, 363 (32.6%) had an intrapartum co nsultation, usually for failure to progress (50.1%) or fetal distress (12.7%). More than 80% of intrapartum consultations were associated wi th induction and augmentation of labour. CONCLUSION Family physicians can continue to care for many non-low-risk women, usually with the hel p of obstetricians. Consultations were obtained for many women at low risk. We need to reevaluate whether some mandatory consultations are n ecessary in family practice obstetrics.