Obstetric Anesthesiology 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.

The educational components of the Emory Anesthesiology Obstetrics program include both subspecialty-specific and multidisciplinary educational activities which include:

• 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
• TransThoracic Echocardiography (TTE) Elective

Labor and Delivery at Grady Memorial Hospital (4 months)

The Grady Memorial Hospital labor and delivery unit is a public practice service that does about 2,500-3000 deliveries per year providing both routine and high-risk care. Ex- Utero Intrapartum Treatment (EXIT) procedures are also performed at Grady Hospital and this has become one of the top referral centers for these procedures in the southeastern region.  This facility has a fully-equipped, dedicated OB High-Risk Unit in which ill parturients are co-managed with obstetricians, pulmonologists, cardiologists, and other medical specialties.

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).

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 develop 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.

• Transthoracic Echocardiography (1-2months)
  • The OB anesthesiology fellow will work alongside cardiac anesthesiologists to obtain high-quality images and Doppler information necessary for the performance of a focused TTE examination according to the ASE/SCA guidelines. This elective rotation can be combined with research months and will be located at Grady Hospital.  The trainee will acquire and apply knowledge of transthoracic focused echocardiography as it is related to the peri-partum patient with recommendations to help guide necessary interventions 

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
• Neuraxial anesthesia methods for cesarean sections
• 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.

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 that 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.

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.