Obstetric Anesthesia Fellowship

About the program

Our ACGME-accredited subspecialty program in Obstetric Anesthesiology is structured to ensure optimal patient care while providing fellows the opportunity to develop skills in clinical care and judgment, teaching and research.

The fellow will have the opportunity to develop advanced clinical expertise through the following activities:

• Overseeing anesthetic management for patients on the Obstetric Special Care Unit, including labor analgesia and anesthetic care for operative deliveries in high-risk obstetric populations.

• Providing anesthetic services for a range of non-delivery obstetric procedures, such as cervical cerclage, dilation and curettage (D&C), and select minor fetal interventions (e.g., fetal shunt placement).

• Coordinating patient care on the Obstetric Special Care Unit in close collaboration with obstetricians, maternal–fetal medicine specialists, nursing teams, and pediatric providers.

• Participating as a core member of the multidisciplinary care team managing complex deliveries in the Main Operating Room and intensive care units, including cases involving placenta accreta spectrum, life-threatening cardiac disease, obstetric trauma, and other high-risk scenarios.

• Engaging in the preoperative evaluation of pregnant patients with preexisting cardiac conditions, as well as individuals with placenta accreta spectrum, through our multidisciplinary prenatal clinic.

• Working collaboratively with neonatologists and fetal care surgeons at Cincinnati Children’s to provide anesthetic services at the Cincinnati Children’s Fetal Care Center, supporting healthy parturients delivering infants with high-risk fetal anomalies.

• Developing comprehensive anesthetic care plans for major fetal procedures performed at Cincinnati Children’s Hospital, including myelomeningocele repair, fetoscopic endotracheal occlusion (FETO), and ex utero intrapartum treatment (EXIT) procedures.

In addition, the fellow will have opportunities to:

• Provide education and mentorship to residents and medical students rotating on the Obstetric Anesthesia service.

• Participate in a structured Quality Improvement (QI) curriculum designed to build core QI competencies and support the fellow’s leadership in advancing divisional initiatives.

• Conduct independent research in the field of obstetric anesthesiology.

• Present scholarly work at national meetings, including the American Society of Anesthesiologists (ASA) Annual Meeting and the Society for Obstetric Anesthesia and Perinatology (SOAP) Annual Meeting.

• Advance their knowledge of obstetric anesthesiology through a comprehensive didactic curriculum integrated with the SOAP Fellows’ Webinar series.

Facilities

University of Cincinnati Medical Center

The University of Cincinnati Medical Center is a tertiary care center in Cincinnati, Ohio serving southwest Ohio, northern Kentucky, and eastern Indiana. This active teaching hospital is home to the only level 1 trauma center and one of two level 3 NICUs in this large area. Located directly across the street, Cincinnati Children’s Hospital Medical Center is closely affiliated with UCMC and directly connected through the Fetal Care Center and the patients that receive care jointly. Given these resources, and a well-established fetal surgery program, we provide care to a wide variety of patients and their babies, often referred from great distances.

Our labor and delivery unit has 13 labor rooms, 6 triage rooms, 3 operating rooms and a 4 bed OB PACU. Approximately 2500 patients deliver at our hospital each year. Anesthesia care is provided for labor analgesia, cesarean section anesthesia, post-partum tubal ligations, D&C, cerclage placement/ removal and for minor fetal surgical procedures such as thoracentesis, shunt placements and fetal blood transfusions. We utilize a variety of anesthesia types in patient care including epidural, spinal, combined spinal-epidural (CSE), continuous spinal and general endotracheal anesthesia. We also provide post procedure anesthesia care for patients who have undergone major fetal surgical procedures such as open menigomyelocele repair at Cincinnati Children’s Hospital Medical Center. We have a medical consultation service and center for perioperative care to aid in assessment and care coordination prior to delivery for obstetric patients with underlying medical issues. This is a high risk unit with a Level 3 NICU which means that a large number of our patients have comorbidities complicating their pregnancy and many of our babies are born with medical issues or extreme prematurity.

Cincinnati Children’s Hospital and Medical Center (CCHMC)

One major advantage to our fellowship program is our integrated collaboration with Cincinnati Children’s, ranked #1 pediatric hospital by the U.S. News and World Report and the only hospital in the region with a Level 4 NICU. Fellows have the opportunity to work on their newly renovated Fetal Care Center for delivery of pregnant patients with high risk infants, in collaboration with renowned fetal care surgeons and maternal fetal medicine specialists. CCHMC is one of the only hospitals in the nation to provide major fetal care surgeries, including myelomeningocele repairs, selective fetoscopic laser photocoagulation, fetoscopic endotracheal occlusion and EXIT procedures.

West Chester Hospital

In addition to UCMC, we provide obstetric anesthesia care at the Maternity Unit at West Chester Hospital which is a lower risk population and a Level 2B NICU. This unit has 8 labor rooms and 2 ORs.

Faculty

• Andrea Girnius, MD
  Fellowship Director
• Mary Roberts, MD
  Fellowship APD
• Tyler Guidugli, DO
• Jasveen Chadha, MD
• Steve Amatangelo, MD
• Kristin Horton, MD
• John Crowe, MD
• Chelsey Thomas, MD
• Hyndhavi Chowdary, MD
• Thomas James, MD
• Rupi Parikh, MD (CCHMC)