Obstetric Anesthesia Section Chief
Abhinava Madamangalam, MBBS

The obstetric anesthesia rotation at Augusta University is structured around one-month blocks available for CA-2 and CA-3 residents. Each month, three residents rotate daily to provide 24-hour-a-day care for laboring and expecting mothers.

Our highly diverse patient population consists of both healthy and high-risk parturients. With roughly 2500 deliveries a year, residents will gain experience in placing labor epidurals, combined spinal-epidurals, spinal anesthetics, and in the anesthetic management of a variety of high-risk situations including pre-eclampsia, HELLP syndrome, placenta abruption, placenta accreta/increta/percreta, uterine rupture, and multiple gestations.

The Children’s Hospital of Georgia, which houses one of the region’s leading perinatal centers with a level IV neonatal intensive care unit, is a part of AU Health. It is not uncommon to provide peripartum care for mothers delivering at 23-24 weeks gestation (>500g) and neonates with severe congenital malformations that require advanced support.

We house eight labor and delivery rooms. We also have one reserved operating room for cesarean sections and the ability to open other operating rooms for obstetric care as needed. Residents gain experience responding to a variety of peri- and intra-operative emergencies such as hemorrhage, uterine atony, difficult airways, and the management of maternal cardiopulmonary disease, sickle cell disease, HIV, super morbid obesity, and poly-substance abuse.

Resident education begins with the pre-operative assessment to identify women at high risk of complications. Residents will learn to tailor each anesthetic plan to ensure the highest level of safety for both mother and fetus. The rotation provides anatomical models for practicing neuraxial anesthesia and incorporates the use of ultrasound to enhance placement of neuraxial anesthesia in patients with abnormal anatomy and/or morbid obesity. During the rotation, residents will learn to work in an environment that promotes constant and ongoing communication between the obstetricians, labor and delivery nurses, and patients which enhances every aspect of maternal and fetal well being.