Obstetric cardiac arrest Let’s look at the big picture…. So among 355,000 obstetric anaesthetic interventions in a year in UK (delivered to approximately 50% of all births & at all times of day and night almost exclusively in the NHS) Incidence of obstetric cardiac arrest -Epidural for labour 1 in 56,500 - any anaesthesia for LSCS 1 in 8,500 -All epidurals & spinals 1 in 17,000 -all GAs 1 in 1,200 These fall into ‘big data’ They are no substitute for an RCT in assessing safety (except no such RCT exists or is likely to) There will clearly be confounding by intention (the very highest risk cases more likely to have GA) …..but they do provide welcome evidence of the absolute safety of obstetric epidurals& spinals (& possibly relative safety compared to GA…) I think a credit to UK obstetric anaesthesia & wider surgical & midwifery teams. associationofanaesthetists-p…