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The Division of Obstetric Anesthesia is responsible for anesthesia coverage of the Labor and Delivery Suite at the Sloane Hospital for Women in the new Children’s Hospital of New York (CHONY) on the main campus at 168th Street, and the L&D Suite at the Allen Pavilion at the northern tip of Manhattan. In addition, we provide a high-risk consultation service, coordindate with Obstetrics and Gynecology to run the Critical Care Obstetric service, and provide a patient education program. For information about our patient seminars, please click here or call 212-342-2028. In 2007, there were over 4300 deliveries per year at the main campus and about 2700 at the Allen Pavilion.Many patients are high risk or critically ill parturients, requiring close consultation and cooperation between the Obstetrics and Gynecology and Anesthesia Departments. At our main campus, where most resident training takes place, the labor analgesia rate is ~85%. The cesarean section rate is about 35%, reflecting the referral nature of much of the practice. There is a special emphasis on Critical Care Obstetrics, with three high-risk double-bedded room on the labor suite equipped for full hemodynamic monitoring and other aspects of critical care for parturients with cardiopulmonary and other critical diseases. Approximately 96% of the cesarean sections are performed using regional anesthesia. A variety of techniques of regional analgesia for labor are utilized, including epidural, spinal, combined spinal epidural (CSE), and there is extensive use of patient controlled epidural analgesia (PCEA). The Division of Obstetric Anesthesia provides residency and post-graduate fellowship training in state of the art techniques and strategies of labor analgesia and obstetric anesthesia. Faculty from the Division of Obstetric Anesthesia provide coverage of the main campus Labor and Delivery Suite 24 hours a day, 7 days a week. The provision of patient care and resident supervision 24/7 by subspecialty obstetric anesthesiologists is only practiced at a handful of institutions, and is a major strength of the Division. Most residents rotate through the labor suite three times during their 3 years as residents. The residents will care for all patients on the Labor and Delivery floor, including the most complex obstetric or medical cases, and will perform consultations along with the Fellow and/or Attending. A typical distribution of cases for each resident during a 4-week rotation is: - Epidural analgesia for labor: 30-40 (~65 % will be combined spinal-epidural) The lecture series and other educational programs are another strength of the Division. Didactic lecture/discussions or case presentations take place each morning during teaching rounds, and significant efforts are made to “protect” resident learning time. A syllabus of topics is covered during the rotation and a CD of the outlines and discussion questions from the syllabus is given to each resident, along with a variety of other recommended reading materials. When residents on the rotation are mostly senior residents, rounds are geared toward more advanced and/or research topics. We have an active research program. Recent and current research in the Division and in the Department relevant to obstetric anesthesia include a variety of studies of drug combinations and techniques for labor analgesia and post-partum pain relief, a program of research into the role of genetic polymorphisms of specific proteins and pregnancy complications (preterm labor, preeclampsia) and response to anesthesia, and studies of gender differences in pain sensitivity and the effectiveness of different treatments. In the past 6 years, abstracts from this Division have won the “Best Paper of the Meeting” award at the annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP) 4 times, and once at the International Society for Anesthetic Pharmacology. To see a selected list of recent publications from the Division, please click here.Faculty: Richard Smiley, MD, PhD, (Chief of Division) Current Fellows 2008/09: For further information, write or contact: Richard Smiley, MD, PhD |
