The MUSC Obstetric Service is an active tertiary care unit performing approximately 2,000 deliveries annually. Anesthesiologists in the Division of Obstetric Anesthesia offer expertise in obstetric anesthesia and are involved in the management of high-risk pregnancies and are available for pre-delivery consultation. Between 20 and 30 percent of the patient population is high risk. Staff anesthesiologists are available in the hospital 24 hours a day to provide care for obstetric patients. All staff anesthesiologists are extensively experienced in OB anesthesia. We provide a full range of anesthetic services to cover the approximately 2,200 deliveries a year we see on the labor and delivery suite.
The Obstetric Section provides all major modalities of labor analgesia including neuraxial narcotics, combined spinal-epidural analgesia (CSE), and patient-controlled epidural analgesia (PCEA). Our epidural rate is approximately 80 percent for laboring patients and c-section rate is approximately 20 percent. We provide a very efficient service for our laboring parturients with an average response time of 6.7 minutes for placement of a laboring epidural. We offer an on-demand consult service, which has been very busy this year. On the obstetric service, we continue to enjoy great relationships with our Maternal Fetal Medicine (MFM) group under the direction of Dr. Donna Johnson. Through the efforts of Deborah Brown, nursing manager of the Labor and Delivery Unit, we have maintained a full nursing compliment; this has allowed for an improvement in care delivery. The expansion of the Neonatal Intensive Care Unit and the recruitment of additional MFM faculty have led to an increase in our high-risk patient population. We are continually faced with interesting and challenging clinical problems. The Labor and Delivery suite has two operating rooms, two exam rooms and nine rooms for laboring patients.
Resident education is a major mission of the section. We have two residents (1 CA-1 and CA-3) rotating on obstetrical anesthesia at all times. Rotations are done in epochs of one month. With a good balance of high-risk and normal pregnancies, we are confident that our residents get an education in obstetrical anesthesia that is second-to-none. We continue to see increasing interest in CA-3 and advanced clinical track rotations on the obstetric service. During the preliminary stage, the new junior residents are closely supervised and advised about clinical techniques and management of high risk and normal patients. Residents always perform the techniques under direct supervision. However, senior residents are allowed to place laboring epidurals independently, but a staff anesthesiologist is always in close proximity for any advice or assistance. Board rounds are performed every morning and are a compulsory part of the clinical management. During this time, residents absorb considerable information about the patients in the labor and delivery area. All residents are required to meet with Dr. Hebbar prior to start of the rotation in order to review the Goals and Objectives of the rotation. CA-1s take a pre-test at the beginning of the rotation. At the end of the rotation, both CA-1s and CA-3s do a post test and mock orals in OB anesthesia.
There is on-going collaborative research work with our MFM Division. In addition, there is on-going clinical research by our faculty. Residents are encouraged to be involved with on-going research. We have had resident abstracts related to OB anesthesia presented at the past two annual meetings of the Society for Obstetric Anesthesia and Perinatology (SOAP) and the IARS.
Obstetric Anesthesia Faculty
|Ryan Gunselman, MD|
|Catherine Tobin, MD|
|Latha Hebbar, MD, FRCA, FFARCS (I)|
Director, Obstetric Anesthesia
|Robert D. Warters, MD|
|Laura Roberts, MD|
|Sylvia Wilson, MD|
|David Stoll, MD|