Ten faculty members of the Division of Obstetric Anesthesiology provide subspecialty care in the Labor and Delivery Suites. Over the past year, the Division cared for over 1,500 parturients; thirty-one percent delivered by cesarean section. Sixty-nine percent of women delivering vaginally received neuraxial labor analgesia. Obstetric anesthesiologists also cared for 60 patients undergoing gynecologic surgery performed in Labor and Delivery, and provided anesthesia for approximately one-third of the 100 fetal surgery cases performed at UMMC, including placental laser, fetal shunts and EXIT procedures (intubation of the neonatal trachea during continued placental perfusion). The team of obstetric anesthesiologists in the department have special expertise in the care of high-risk pregnancy.
UMMC serves a mainly urban population and is also a transport hospital for the rest of the state; over 90 percent of the Division’s obstetric patients are considered to be high-risk. Many patients have co-existing cardiac, neurosurgical, and respiratory diseases. Obstetric anesthesiologists are increasingly seeing patients with previous anesthetic problems related to super-morbid obesity or other issues. The Division’s faculty members address complex fetal problems that often require fetal intervention or preterm delivery. Obstetric anesthesiologists also provide bedside critical care services for critically-ill parturients, in collaboration with faculty from the Department of Obstetrics and Gynecology. In addition, all first-year obstetric residents as well as second year maternal-fetal medicine fellows rotate on the obstetric anesthesiology service.
During the past year, office and sleeproom space were upgraded for both faculty and residents. Faculty members Dr. Shobana Bharadwaj and Dr. Andrew Malinow have been serving in leadership roles to help set the standards of care for parturients and their neonates within the UMMC system and in hospitals throughout the State of Maryland. Dr. Bharadwaj and Dr. Malinow mentor resident presentations at regional and national conferences and have incorporated a resident role in their research analysis of the obstetric anesthesiology database. An original contributor, Dr. Malinow has recently revised his chapter for the fifth edition of Chestnut’s Obstetric Anesthesia.
The Division was one of the first groups nationwide to be approved for the ACGME fellowship in Obstetric Anesthesiology. Dr. Bharadwaj was instrumental in this process and serves as the Fellowship Director. The first ACGME OB Anesthesiology fellow began in July 2013. Each morning, faculty obstetric anesthesiologists conduct a daily educational session that is well received by both junior and senior anesthesiology residents who rotate on the service. Residents consistently score highly on the obstetric anesthesiology specific portions of the American Board of Anesthesiology in-training and American Board of Anesthesiology written exams.
Each resident provides anesthesia for about 130 parturients during their training, including many opportunities for general anesthesia as well as all neuraxial techniques. The Division also hosts medical students during their junior and senior rotations in anesthesiology; Dr. Bharadwaj presents small group sessions for these students on regional anesthesia she also conducts a robust simulation scenario that involves Anesthesiology and Obstetric residents as well as Labor and Delivery nurses.
Read about our Obstetric Anesthesiology Fellowship.