Obstetric Anesthesia Rotation

The division of Obstetric Anesthesia is dedicated to the care of the obstetric patient.  From the low risk healthy parturient requesting a free delivery with minimal intervention, to the critically ill parturient requiring a multidisciplinary team approach, the division of obstetric anesthesia works continuously to provide its patients immediate and constant care.

Our anesthesia care team includes a number of fellowship trained anesthesiologists in obstetric anesthesia as well as experienced nurse anesthetists dedicated to obstetric anesthesia.

The division of obstetric anesthesia provides a wide range of services to our laboring patients. We provide analgesia with a number of different techniques including epidurals, combined spinal epidurals and spinal narcotics allowing parturients to be almost instantaneously comfortable as well as walk or move freely during uncomplicated labor and deliveries.  Our future plans include modifying epidural analgesia to allow for patient controlled epidural analgesia allowing patients to have better control over their pain relief in labor.

To improve overall care of the obstetric patient we have worked with the department of obstetrics in developing a multidisciplinary approach for the care of the medically complicated high risk parturient.  We participate in obstetric morning conference to provide coordinated care for high risk inpatients.  We also provide antenatal out-patient consultation with parturients to develop anesthesia care plans for high-risk deliveries.

Along with our practice of obstetric anesthesia, we have continued to provide care for patients requiring minor gynecologic surgery including D&Cs and immediate post partum tubal ligations.

The division of obstetric anesthesia is committed to providing excellence in clinical care along with continued dedication to the academic mission of education to both  medical students, post graduate nursing students and obstetric and anesthesia  residents.

What's it Like?
Here's a chance to peek into a typical day in the life of the Obstetric Anesthesia Resident. 

A typical day starts at 6:30 am when we arrive on the OB ward.  Our first task is to obtain sign-out from the on-call person. They will inform us of any preceding events which occurred that we will need to follow up on, any potential cesarean sections, and the patients with current working epidurals.  We then review the day’s operative room schedule and the status of the current patients on the board.  The key in OB is preparation, so we set up the operating rooms in anticipation of a worst case scenario; the crash cesarean section with the difficult airway usually found in the OB patient. The remainder of my morning and day will be spent seeing patients, conducting the initial history and physical, follow-up post-operative examinations, placement of epidurals, or the cesarean section for the laboring patient who is failing to progress.

Today, as we were preparing for a caesarean section on a parturient who is having a child with a left hypoplastic heart., a patient came into the ward at the latter stages of labor demanding an epidural. We quickly placed the epidural and then proceeded to the scheduled cesarean section.  A delivery of this nature, demands a multidiscipline approach, with the involvement of other specialties within the institution, which will help optimize the child and mother prior to the delivery and provide excellent neonatal care to the newborn in AMC’s state of the art 60+ bed NICU. Working within this team allows me to give the very best care to both the mother and her child as well as gain key experience we will need for our future careers as anesthesiologists.

As a first year anesthesia resident, we are allowed an increasing range of responsibilities, yet always have readily available the guidance of the anesthesia attending. As we gain more experience during my rotation, we are allowed a greater degree of independence, such as the taking of OB call. Our aspirations and expectations at the end of this rotation, is to become both technically skilled in regional anesthesia required for the OB patient, but more importantly to gain the clinical insight required to be a good perioperative anesthesia physician. This rotation which is devoted to OB anesthesia has provided an opportunity to improve my procedural skills,  further develop our ability to respond to and provide care to patients in emergency settings, and it was a unique opportunity to share a more continual physician-patient relationship with our patients which guaranteed are usually very happy to see me.