Our fellowship includes a didactic component as well as extensive clinical experience. We offer didactic lectures, journal clubs, and conferences to help you master the subspecialty of obstetric anesthesia. There are also opportunities for interdisciplinary educational initiatives with our obstetric colleagues, residents, and nurses. We cover a broad area of obstetric anesthesiology topics, including:
- Maternal physiology
- Embryology and teratogenicity
- Fetal and placental physiology and pathophysiology
- Neonatal physiology and neonatal resuscitation
- Obstetric management of labor, including normal labor and abnormal labor and indications for urgent and emergent delivery
- Tocolytic therapy
- Pain of labor, pain pathways
- Local anesthetic use in obstetrics, including recognition and treatment of complications
- Neuraxial opioid use in obstetrics plus recognition and treatment of complications
- Regional anesthetic techniques as well as recognition and treatment of complications
- General anesthesia use in obstetrics and recognition and treatment of complications
- Anesthetic and obstetric management of obstetric complications and emergencies, including preeclampsia, eclampsia, placental abruption, placenta previa, placenta accreta, vasa previa, uterine rupture, uterine atony, amniotic fluid embolism, and umbilical cord prolapse
- Medical disease and pregnancy:, especially hypertensive disorders, morbid obesity, respiratory disorders, cardiac disorders, endocrine disorders, autoimmune disorders, hematologic and coagulation disorders, neurologic disorders, substance abuse, HIV infection, and AIDS
- Cardiopulmonary resuscitation and advanced cardiac life support of the pregnant women
- Postpartum tubal ligation
- Post-operative pain management in the parturient
- Non-obstetric surgery during pregnancy
- Effects of maternal medications on breastfeeding
- Ethical issues during pregnancy
- Principles and ethics of research in pregnant women, fetuses, and neonates
- Organization and management of an obstetric anesthesia service
- Transport and monitoring of critically ill parturients within the hospital and between hospitals
- Maternal mortality
- Medical economics and public health of women during reproductive years as it applies to obstetric anesthesiology, such as availability of obstetric analgesia and reducing cesarean section rates
Our fellows, operating under the supervision of one of the obstetric anesthesia attendings, manage the labor and delivery suite, including providing direct patient care and supervision of anesthesiology residents. Ten months of the fellowship will be dedicated to clinical work; this includes providing direct patient care, supervising and teaching junior residents, and participating in rotations in the neonatal intensive care unit, the Maternal Fetal Medicine (MFM) service, and the Blood Bank. Our Department has a strong relationship with the MFM team and all the obstetricians, which allows collaboration in caring for our most challenging patients starting early in their pregnancies. We have a very active consultation service where patients are seen antepartum to help develop an anesthetic and delivery plan in collaboration with the MFM team. Interdisciplinary conferences with multiple medical services is likewise common.
We expect that our fellows will become proficient beyond the level of the non-obstetric anesthesiologist in providing anesthesia care for women during labor and vaginal delivery and for women undergoing cesarean delivery. In particular the fellow will gain experience in caring for the woman with complex medical issues including abnormal placentation, cardiac disease, and coagulopathies.
Our fellows become involved in quality initiatives on the labor and delivery suite, including principal investigator meetings, peer review of medical records, and development of obstetric anesthesia policy. Fellows are encouraged to participate in a quality-related project.
Our fellows benefit from our extensive academic involvement in both national and international professional societies and symposia and devote about 25 percent of their time to academic pursuits.
Fellows can participate in ongoing research projects on the labor and delivery suite. We also encourage you to develop your own projects, write review articles, and submit case reports. The goal is to present at a national anesthesia meeting. In addition, journal club meets every other week to review and discuss recent publications.
We allow you to attend one national meeting per year and spend up to five days at conferences in the area of obstetric anesthesiology. We can provide up to $2,500 for conference-related expenses. This meeting is in addition to any meeting where you present an abstract.
Our faculty is actively involved in research on topics including:
- Obstetric outcomes
- Safety of anesthetic agents, coagulation, and analgesic techniques
- Intrathecal preservative-free morphine vs. hydromorphone for post cesarean analgesia
- Platelet patterns in women with preeclampsia
- Utility and characterization of platelet mapping and function in preeclampsia
- Accuracy of thromboelastographic analysis of fibrinogen levels in the parturient
- Comparative work flow analysis of an optical based quantitative blood loss tool in a simulated environment
- Comparative accuracy of different modalities of quantitative blood loss
- Etiology and patient risk factors for ICU admissions from the labor floor
- P6 pressure bands in the prevention of shivering during cesarean delivery
- Thromboelastometry in cesarean delivery at quantified levels of blood loss; obstetric hemorrhage; in the parturient on anti-coagulants; in the parturient with coagulation disorder; and in the parturient with an IUFD
- Coagulation profile in women with recent fetal demise
Our faculty members publish regularly in peer-reviewed journals. Some of the most recent publications are:
Katz D, Beilin Y, Review of the Alternatives to Epidural Blood Patch for Treatment of Postdural Puncture Headeache. Anesthesia & Analgesia. 2017 PMID: 28079587
Weiner MM, Hamburger J, Beilin Y. The Pregnant patient with cardiac disease. In: Kaplan’s Cardiac Anesthesia, 7th ed. 2016, in press.
Spitzer Y, Beilin Y. Hypertensive Disorders of pregnancy. In: Baysinger C, Bucklin BA, Gambling DR, eds. A Practical Approach to Obstetric Anesthesia, 2nd ed. Philadelphia: Wolters Kluwer Health, 2016, 435-50.
Mathney E, Beilin Y. Successful epidural anesthesia for cesarean delivery in a woman with Fontan repair. J Clin Anesth, 2015; 27:4.
Beilin Y, Spitzer Y. Presumed Group B Streptococcal Meningitis After Epidural Blood Patch. A Case Rep 2015; 4:163-165.
Spitzer Y, Weiner MM, Beilin Y. Cesarean Delivery in a Parturient with Left Ventricular Noncompaction Complicated by Acute Pulmonary Hypertension After Methylergonovine Administration for Postpartum Hemorrhage. A A Case Rep 2015; 4:166-168.
Katz D, Beilin Y. Disorders of Coagulation in Pregnancy. Br J Anaesth 2015; 115: suppl 2:ii75-ii88.