Obstetric Fellowship

The Emory University Department of Anesthesiology offers a one-year ACGME-accredited fellowship in Obstetric Anesthesia. Fellows rotate at both Emory University Hospital Midtown and Grady Memorial Hospital. Together these institutions offer approximately 7,000 deliveries per year. Many of these deliveries are high risk - including both severe co-existing systemic illness as well as patients with issues unique to pregnancy. Neuraxial anesthesia is provided to about 85% of the patients, although a significant experience with general anesthesia remains.

Fellows will interact with perinatologists and neonatologists during rotations in both the MFM Clinic and NICU. The fellow will participate in the education of medical students and residents, and on-going research projects.

The goal of the Emory Anesthesia Obstetric Fellowship program is to develop well-trained, academically-oriented obstetric anesthesiologists who can function in either the private or public setting while taking care of a wide-variety of parturients.

• Monthly OB Anesthesia Journal Club
• Monthly high-risk pregnancy group with cardiology, obstetrics, perinatology, neonatology
• Monthly QEC committee with obstetrics, neonatology, and nursing
• Biweekly didactic lectures
• Weekly departmental Grand Rounds
• Fetal heart rate monitoring course
• Monthly SOAP fellow videoconferences
• National meeting attendance
• NALS certification

Labor and Delivery at Emory University Hospital Midtown (4 months)

The Emory University Hospital Midtown (EUHM) labor and delivery unit is a mixed academic-private practice service which does 3,500-4,000 deliveries per year. The service provides both routine and high-risk obstetrical care. The unit specializes in pregnant patients with significant structural or functional heart disease. These patients are co-managed with obstetricians, perinatologists, and cardiologists (both congenital heart disease and congestive heart failure specialists).

Labor and Delivery at Grady Memorial Hospital (4 months)

The Grady Memorial Hospital labor and delivery unit is a public practice service which does about 3,000-3,500 deliveries per year providing both routine and high-risk care. Also, this facility has a fully-equipped, dedicated OB ICU in which ill parturients are co-managed with obstetricians, pulmonologists, cardiologists, and other medical specialties.

NICU/MFM (1 month)

The neonatal ICU experience and maternal-fetal medicine experience take place at Emory University Hospital Midtown. The NICU at EUHM is a Level 3 nursery with particular experience in head cooling protocols for hypoxic brain injury. Training in neonatal resuscitation including intubation and invasive line placement will be emphasized. The fellow will also attend MFM clinic during this month and will learn to evaluate high-risk parturients, learn to interpret NSTs/OCTs and fetal lung maturity tests as well as developing an understanding of the basics of the ultrasound examination of the fetus and placenta.

Research Time (3 months)

Time is allotted for participation in on-going research projects involving either the OB anesthesia faculty or with projects in conjunction with the obstetric or neonatology faculty. Advanced fellows may be able to prearrange fellow-initiated projects upon consultation with the program director and a faculty mentor.

ECMO Experience

The opportunity to take part in ECMO initiation and weaning will occur during the fellowship year on an ad hoc basis. Relief from other clinical/research duties will permit participation in a few of these procedures. This experience will occur at Children’s Healthcare of Atlanta Egleston campus.

Finally, the fellow will be given the opportunity to participate in on-going research and quality-improvement projects including:

• Multimodal pain therapy strategies following cesarean section
• Noise abatement in emergencies
• Non-pharmacologic treatments for hypotension
• Alternatives to invasive hemodynamic monitoring
• Point-of-care testing for coagulopathy
• Maximizing blood resource allocation/utilization
• General anesthetic safety issues in pregnancy

Development and participation in interdisciplinary research with the obstetric and neonatal services will be highly encouraged.  Ultimately these research/academic activities are meant to result in the first authorship in peer-reviewed publications.

The Obstetric Anesthesia Section of the Emory Department of Anesthesiology provides anesthetic service for 7,000 deliveries annually at two major Atlanta metropolitan hospitals.

Emory University Hospital Midtown (EUHM)

EUHM is a 583 bed, community-based, acute care teaching hospital with a mix of private and Emory University physicians representing 28 specialties.  The hospital provides labor services for approximately 4,000 deliveries annually.  The labor and delivery unit contains 11 dedicated labor suites which can expand to 19 labor rooms during times of peak demand.  This unit also contains 3 state-of-the-art ORs, including one which is specially designed for high-risk deliveries.  Medical, surgical, and congestive heart failure units are readily available for the pre- and post-operative care of high-risk parturients.  There is also a 36 bed Level 3 nursery on site.

Grady Memorial Hospital (GMH)

GMH is a 595 bed, public, Level 1 trauma center providing multispecialty care which is staffed with a mix of Emory University and Morehouse SOM physicians.  The hospital provides labor services for approximately 3,000 deliveries annually.  The labor and delivery unit contains 12 dedicated labor and delivery suites but can expand to 20 labor rooms during times of peak demand.  The unit also contains 4 dedicated ORs, as well as a 7 bed OB ICU.  There is also a 37 bed Level 3 nursery on site.