| Case Volumes | |
|---|---|
| Total number of deliveries | 6,926 |
| Vaginal deliveries | 4,307 (62.2%) |
| Epidural/CSE/Spinal | 3,803 (88.3%) |
| Cesarean deliveries | 2,619 (37.8%) |
| General Anesthesia | 73 (2.8%) |
| Regional + General Anesthesia | 21 (0.8%) |
| Total General Anesthesia | 94 (3.6%) |
Clinical Practice Innovations
The Enhanced Recovery after Cesarean Section program was fully implemented, incorporating obstetric, nursing and anesthetic changes. Anesthesia practice was already in keeping with ERAS recommendations, however some aspects of our practice were improved, such as the use of carbohydrate-containing clear fluids 2 hours before the scheduled surgical time and the use of active warming of patients in the operating room. The ERAC project team is now collecting data post-implementation of the program for future before-and-after analyses.
Special Clinical Programs
Placenta accreta spectrum disorder: The program continues to run at its full capacity, with a refined protocol and excellent outcomes. There has been continued discussion on the possibility of relocating the program from the main operating room to the labor and delivery operating rooms, however until the present date the decision has been to maintain status quo, until further analyses confirm the safety of relocating the program.
Intrauterine fMMC repair: Since its inception in June 2017, the program has had 42 cases. The anesthetic management has been standardized in order to allow for different staff anesthesiologists to be involved with the cases.
Resident Education
We continued to provide teaching in obstetric anesthesia for junior and senior trainees, both thru a didactic component and extensive clinical exposure.
Research
The research activities resumed after the initial slow down due to the COVID 19 pandemic, and were fully restored during this academic year.
The publications associated with the obstetric anesthesia research program can be reviewed in the publications section of the annual report.
Once again, our research program was recognized with awards as follows:
Emil Peska, Wesla Pfeifer, Kristi Downey, Xiang Y Ye, Cynthia Maxwell, Mrinalini Balki, Jose C.A. Carvalho. Oxytocin at elective cesarean delivery: a dose-finding study in people with twin pregnancy. Awarded 1st place during the Best Paper Competition at the 2022 Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Chicago, IL, May 11-15, 2022.
Natalia Portela, Thomas Drew, Lauren Miller, Tess Engel, Jayalakshmi Caliaperumal, Chinaza Egbuta, Jose C.A. Carvalho, Mrinalini Balki. Spontaneous and oxytocin-induced contractility after exposure to intravenous anesthetic agents: an in-vitro study in human myometrium. Awarded 2nd place during the Gertie Marx Competition at the 2022 Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Chicago, IL, May 11-15, 2022. Awarded best paper in Obstetric Anesthesia at the 2022 Annual Meeting of the Canadian Anesthesiologists’ Society, Halifax, NS, June 24-26, 2022.
Julia Casellato, Kristi Downey, Xiang Y Ye, Jose C.A. Carvalho. Changes in sensory block level during a programmed intermittent epidural bolus regimen for labor analgesia: a prospective observational cohort study. Selected for the Gertie Marx Competition during the 2022 Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Chicago, IL, May 11-15, 2022.
Education for Patients and Families: Meet your Anesthesiology
This program, which started in 2012, consists of a bimonthly interactive session presented by a Staff to patients and their partners or support persons. Due to the COVID 19 pandemic, these sessions have been presented virtually.
The University of Toronto Obstetric Anesthesia Conference
This Annual Obstetric Anesthesia Conference has been offered at Mount Sinai Hospital since 2003. It has been on hold for 2 years now (2020 and 2021), given the limitations imposed by the COVID-19 pandemic.
