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Obstetric Anesthesiologists as Perioperative Physicians: Improving Peripartum Care and Patient Safety

  • Obstetric Anesthesia (LR Leffert, Section Editor)
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Abstract

The care of obstetric patients has become challenging due to the changing demographics of the pregnant population. Women with chronic diseases and congenital heart disease live to child-bearing age due to medical and surgical advances. Older and less healthy women become pregnant due to advances in reproductive technologies. Therefore, obstetric anesthesiologists have an increasingly important role in the peripartum period. In this article, we review the role of obstetric anesthesiologists in the antepartum, intrapartum, and postpartum periods. The need for multidisciplinary care of high-risk parturients is discussed, including the role of anesthesiologists in the National Maternal Health Initiative to improve maternal morbidity and mortality.

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References

Papers of particular interest, published recently, have been highlighted as: ∙ Of importance ∙∙ Of major importance

  1. Dennis AT. Transthoracic echocardiography in obstetric anaesthesia and obstetric critical illness. Int J Obstet Anesth. 2011;20:160–8.

    Article  CAS  PubMed  Google Scholar 

  2. Sevdalis N, Hull L, Birnbach DJ. Improving patient safety in the operating theatre and perioperative care: obstacles, interventions, and priorities for accelerating progress. Br J Anaesth. 2012;109:i3–16.

    Article  PubMed  Google Scholar 

  3. Turnbull J, Bell R. Obstetric anaesthesia and peripartum management. Best Pract Res Clin Obstet Gynaecol. 2014;28:593–605.

    Article  PubMed  Google Scholar 

  4. Sachs A, Aronson J, Smiley R. The role of the anesthesiologist in the care of the parturient with cardiac disease. Semin Perinatol. 2014;38:252–9.

    Article  PubMed  Google Scholar 

  5. Campbell KH, Savitz D, Werner EF, et al. Maternal morbidity and risk of death at delivery hospitalization. Obstet Gynecol. 2013;122:627–33.

    Article  PubMed  Google Scholar 

  6. Callaghan WM, Creanga AA, Kuklina EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstet Gynecol. 2012;120:1029–36.

    Article  PubMed  Google Scholar 

  7. Wanderer JP, Leffert LR, Mhyre JM, et al. Epidemiology of obstetric-related ICU admissions in Maryland: 1999–2008. Crit Care Med. 2013;41:1844–52.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Merz WM, Keyver-Paik MD, Baumgarten G, et al. Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center. J Perinat Med. 2011;39:251–6.

    Article  PubMed  Google Scholar 

  9. ACOG Committee Opinion #295: pain relief during labor. Obstet Gynecol. 2004;104:213.

  10. Levin H, LaSala A. Intrapartum obstetric management. Semin Perinatol. 2014;38:245–51.

    Article  PubMed  Google Scholar 

  11. Ko JY, Leffert LR. Clinical implications of neuraxial anesthesia in the parturient with scoliosis. Anesth Analg. 2009;109:1930–4.

    Article  PubMed  Google Scholar 

  12. Kuczkowski KM. Labor analgesia for the parturient with prior spinal surgery: what does an obstetrician need to know? Arch Gynecol Obstet. 2006;274:373–5.

    Article  PubMed  Google Scholar 

  13. Leffert LR, Schwamm LH. Neuraxial anesthesia in parturients with intracranial pathology: a comprehensive review and reassessment of risk. Anesthesiology. 2013;119:703–18.

    Article  PubMed  Google Scholar 

  14. Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med. 2010;35:64–101.

    Article  CAS  PubMed  Google Scholar 

  15. Bharwani F, Macarthur A. Review of a high-risk obstetric anesthesia antepartum consult clinic. Can J Anesth. 2014;61:282–3.

    Article  PubMed  Google Scholar 

  16. Bucklin BA, Hawkins JL, Anderson JR, et al. Obstetric Anesthesia Workforce Survey: twenty year update. Anesthesiology. 2005;103:645–53.

    Article  PubMed  Google Scholar 

  17. D’Alton ME, Bonanno CA, Berkowitz RL, et al. Putting the “M” back in maternal–fetal medicine. Am J Obstet Gynecol. 2013;208:442–8.

    Article  PubMed  Google Scholar 

  18. Kramer MS, Berg C, Abenhaim H, et al. Incidence, risk factors, and temporal trends in severe postpartum hemorrhage. Am J Obstet Gynecol. 2013;209:449.e1-7.

  19. Pronovost PJ, Holzmueller CG, Ennen CS, et al. Overview of progress in patient safety. Am J Obstet Gynecol. 2011;204:5–10.

    Article  PubMed  Google Scholar 

  20. Clark SL, Belfort MA, Dildy GA, et al. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol. 2008;199(36):e1–5.

    Google Scholar 

  21. The Joint Commission. Sentinel Event Alert, Issue 44: Preventing Maternal Death. 2010. http://www.jointcommission.org/sentinel_event_alert_issue_44_preventing_maternaldeath/. Accessed 27 Oct 2014.

  22. Kacmar RM, Mhyre JM, Scavone BM, et al. The use of postpartum hemorrhage protocols in United States academic obstetric anesthesia units. Anesth Analg. 2014;119:906–10.

    Article  PubMed  Google Scholar 

  23. ∙∙D’Alton ME, Main EK, Menard MK, et al. The national partnership for maternal safety. Obstet Gynecol. 2014;123:973–7. The National Partnership for Maternal Safety was formed as part of the initiative to reduce maternal morbidity and mortality and led to the creation of three priority bundles to address the most common preventable causes of maternal death and severe morbidity: peripartum hemorrhage, severe hypertension and venous thromboembolism.

  24. Mhyre JM, D’Oria R, Hameed AB, et al. The maternal early warning criteria: a proposal from the national partnership for maternal safety. Obstet Gynecol. 2014;124:782–6.

    Article  PubMed  Google Scholar 

  25. Lo JO, Mission JF, Caughey AB. Hypertensive disease of pregnancy and maternal mortality. Curr Opin Obstet Gynecol. 2013;25:124–32.

    Article  PubMed  Google Scholar 

  26. Ananth CV, Keyes KM, Wapner RJ. Pre-eclampsia rates in the United States, 1980–2010: age-period-cohort analysis. BMJ. 2013;347:f6564.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Committee on Obstetric Practice. Committee Opinion no. 514: emergent therapy for acute-onset, severe hypertension with preeclampsia or eclampsia. Obstet Gynecol. 2011;118:1465–8.

    Article  Google Scholar 

  28. Jouppila P, Jouppila R, Hollmén A, et al. Lumbar epidural analgesia to improve intervillous blood flow during labor in severe preeclampsia. Obstet Gynecol. 1982;59:158–61.

    CAS  PubMed  Google Scholar 

  29. Einerson BD, Miller ES, Grobman WA. Does a postpartum hemorrhage patient safety program result in sustained changes in management and outcomes? Am J Obstet Gynecol. 2014. doi:https://doi.org/10.1016/j.ajog.2014.07.004.

  30. Toledo P, McCarthy RJ, Hewlett BJ, et al. The accuracy of blood loss estimation after simulated vaginal delivery. Anesth Analg. 2007;105:1736–40.

    Article  PubMed  Google Scholar 

  31. Toledo P, McCarthy RJ, Burke CA, et al. The effect of live and web-based education on the accuracy of blood-loss estimation in simulated obstetric scenarios. Am J Obstet Gynecol. 2010;202(400):e1–5.

    Google Scholar 

  32. Toledo P, Eosakul ST, Goetz K, et al. Decay in blood loss estimation skills after web-based didactic training. Simul Healthc. 2012;7:18–21.

    Article  PubMed  Google Scholar 

  33. Pratt SD. Focused review: simulation in obstetric anesthesia. Anesth Analg. 2012;114:186–90.

    Article  PubMed  Google Scholar 

  34. Pratt SD. Recent trends in simulation for obstetric anesthesia. Curr Opin Anaesthesiol. 2012;25:271–6.

    Article  PubMed  Google Scholar 

  35. Lipman SS, Daniels KI, Carvalho B, et al. Deficits in the provision of cardiopulmonary resuscitation during simulated obstetric crises. Am J Obstet Gynecol. 2010;203(179):e1–5.

    Google Scholar 

  36. ∙ Shamshirsaz AA, Salmanian B, Fox KA, et al. Maternal morbidity in patients with morbidly adherent placenta treated with and without a standardized multidisciplinary approach. Am J Obstet Gynecol. 2014. doi:https://doi.org/10.1016/j.ajog.2014.08.019. A standardized multidisciplinary approach for patients with morbidly adherent placentas was associated with improved maternal outcomes.

  37. Shields LE, Wiesner S, Fulton J, et al. Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety. Am J Obstet Gynecol. 2014. doi:https://doi.org/10.1016/j.ajog.2014.07.012.

  38. ∙ Kostopanagiotou G, Kalimeris K, Pandazi A, et al. The role of the post-anaesthesia care unit in the management of high-risk obstetric patients. Arch Med Sci. 2011;7:123–6. The post-anesthesia care unit can be a feasible option for observation of high-risk patients after cesarean delivery.

  39. ∙∙ Royse CF, Canty DJ, Faris J, et al. Core review: physician-performed ultrasound: the time has come for routine use in acute care medicine. Anesth Analg. 2012;115:1007–28. Transthoracic echocardiography can be used for point-of-care assessments in acute care settings in the perioperative area. Goal-focused examination protocols are available for rapid assessments and have been used in the specialties of anesthesiology and intensive care for diagnosis and management of clinically significant pathology.

  40. Lee A. Ultrasound in obstetric anesthesia. Semin Perinatol. 2014;38:349–58.

    Article  PubMed  Google Scholar 

  41. Vallejo MC, Phelps AL, Singh S, et al. Ultrasound decreases the failed labor epidural rate in resident trainees. Int J Obstet Anesth. 2010;19:373–8.

    Article  CAS  PubMed  Google Scholar 

  42. Sahin T, Balaban O, Sahin L, et al. A randomized controlled trial of preinsertion ultrasound guidance for spinal anaesthesia in pregnancy: outcomes among obese and lean parturients: ultrasound for spinal anesthesia in pregnancy. J Anesth. 2014;28:413–9.

    Article  PubMed  Google Scholar 

  43. Arzola C, Davies S, Rofaeel A, et al. Ultrasound using the transverse approach to the lumbar spine provides reliable landmarks for labor epidurals. Anesth Analg. 2007;104:1188–92.

    Article  PubMed  Google Scholar 

  44. Balki M, Lee Y, Halpern S, et al. Ultrasound imaging of the lumbar spine in the transverse plane: the correlation between estimated and actual depth to the epidural space in obese parturients. Anesth Analg. 2009;108:1876–81.

    Article  PubMed  Google Scholar 

  45. Sahota JS, Carvalho JC, Balki M, et al. Ultrasound estimates for midline epidural punctures in the obese parturient: paramedian sagittal oblique is comparable to transverse median plane. Anesth Analg. 2013;116:829–35.

    Article  PubMed  Google Scholar 

  46. Shaikh F, Brzezinski J, Alexander S, et al. Ultrasound imaging for lumbar punctures and epidural catheterisations: systematic review and meta-analysis. Br Med J. 2013;346:f1720.

    Article  Google Scholar 

  47. Carvalho JC. Ultrasound-facilitated epidurals and spinals in obstetrics. Anesthesiol Clin. 2008;26:145–58.

    Article  PubMed  Google Scholar 

  48. Ellinas EH, Eastwood DC, Patel SN, et al. The effect of obesity on neuraxial technique difficulty in pregnant patients: a prospective, observational study. Anesth Analg. 2009;109:1225–31.

    Article  PubMed  Google Scholar 

  49. Lee AJ, Ranasinghe JS, Chehade JM, et al. Ultrasound assessment of the vertebral level of the intercristal line in pregnancy. Anesth Analg. 2011;113:559–64.

    PubMed  Google Scholar 

  50. de Locks GF, Almeida MC, Pereira AA. Use of the ultrasound to determine the level of lumbar puncture in pregnant women. Rev Bras Anestesiol. 2010;60:13–9.

    Google Scholar 

  51. Margarido CB, Mikhael R, Arzola C, et al. The intercristal line determined by palpation is not a reliable anatomical landmark for neuraxial anesthesia. Can J Anaesth. 2011;58:262–6.

    Article  PubMed  Google Scholar 

  52. Kim JT, Bahk JH, Sung J. Influence of age and sex on the position of the conus medullaris and Tuffier’s line in adults. Anesthesiology. 2003;99:1359–63.

    Article  PubMed  Google Scholar 

  53. Reynolds F. Damage to the conus medullaris following spinal anaesthesia. Anaesthesia. 2001;56:238–47.

    Article  CAS  PubMed  Google Scholar 

  54. Grau T, Leipold RW, Fatehi S, et al. Real-time ultrasonic observation of combined spinal-epidural anaesthesia. Eur J Anaesthesiol. 2004;21:25–31.

    CAS  PubMed  Google Scholar 

  55. Tran D, Kamani AA, Al-Attas E, et al. Single-operator real-time ultrasound-guidance to aim and insert a lumbar epidural needle. Can J Anaesth. 2010;57:313–21.

    Article  PubMed  Google Scholar 

  56. Menacé C, Choquet O, Abbal B, et al. Real-time ultrasound-guided epidural anaesthesia technique can be improved by new echogenic Tuohy needles: a pilot study in cadavers. Br J Anaesth. 2014;113:299–301.

    Article  PubMed  Google Scholar 

  57. Yu S, Tan KK, Shen CY, et al. Ultrasound guided automatic localization of needle insertion site for epidural anesthesia. In: Proceedings of IEEE International conference on mechatronics and automation, Takamatsu, Japan. 2013. doi:https://doi.org/10.1109/ICMA.2013.6618049.

  58. Yu S, Tan KK, Sng BL, et al. Automatic identification of needle insertion site in epidural anesthesia with a cascading classifier. Ultrasound Med Biol. 2014;40:1980–90.

    Article  PubMed  Google Scholar 

  59. Haji DL, Royse A, Royse CF. Review article: clinical impact of non-cardiologist-performed transthoracic echocardiography in emergency medicine, intensive care medicine and anaesthesia. Emerg Med Australas. 2013;25:4–12.

    Article  PubMed  Google Scholar 

  60. Cowie BS. Focused transthoracic echocardiography in the perioperative period. Anaesth Intensiv Care. 2010;38:823–36.

    Article  CAS  Google Scholar 

  61. Canty DJ, Royse CF, Kilpatrick D, et al. The impact of pre-operative focused transthoracic echocardiography in emergency non-cardiac surgery patients with known or risk of cardiac disease. Anaesthesia. 2012;67:714–20.

    Article  CAS  PubMed  Google Scholar 

  62. Berg CJ, Callaghan WM, Syverson C, et al. Pregnancy-related mortality in the United States, 1998 to 2005. Obstet Gynecol. 2010;116:1302–9.

    Article  PubMed  Google Scholar 

  63. Cowie B, Kluger R. Evaluation of systolic murmurs using transthoracic echocardiography by anaesthetic trainees. Anaesthesia. 2011;66:785–90.

    Article  CAS  PubMed  Google Scholar 

  64. Royse CF, Haji DL, Faris JG, et al. Evaluation of the interpretative skills of participants of a limited transthoracic echocardiography training course (H.A.R.T. scan course). Anaesth Intensiv Care. 2012;40:498–504.

    Article  CAS  Google Scholar 

  65. Vignon P, Dugard A, Abraham J, et al. Focused training for goal-oriented hand-held echocardiography performed by noncardiologist residents in the intensive care unit. Intensiv Care Med. 2007;33:1795–9.

    Article  Google Scholar 

  66. Fredericksen CA, Juhl-Olsen P, Nielsen DG, et al. Limited intervention improves technical skill in focus assessed transthoracic echocardiography among novice examiners. BMC Med Educ. 2012;12:65.

    Article  Google Scholar 

  67. McClure JH, Cooper GM, Clutton-Brock TH, et al. Saving mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006–2008: a review. Br J Anaesth. 2011;107:127–32.

    Article  CAS  PubMed  Google Scholar 

  68. Jayaram A, Bowen MP, Deshpande S, et al. Ultrasound examination of the stomach contents of women in the postpartum period. Anesth Analg. 1997;84:522–6.

    CAS  PubMed  Google Scholar 

  69. American Society of Anesthesiologists Task Force on Obstetric. Anesthesia. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007;106:843–63.

    Article  Google Scholar 

  70. Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume. Br J Anaesth. 2014;113:12–22.

    Article  PubMed  Google Scholar 

  71. Arzola C, Cubillos J, Perlas A, et al. Interrater reliability of qualitative ultrasound assessment of gastric content in the third trimester of pregnancy. Br J Anaesth. 2014;113:1018–23.

    Article  CAS  PubMed  Google Scholar 

  72. ∙Cubillos J, Tse C, Chan VW, et al. Bedside ultrasound assessment of gastric content: an observational study. Can J Anaesth. 2012;59:416–23. Gastric ultrasonography can qualitatively differentiate among an empty stomach, a stomach containing liquid, and a stomach containing solid food.

  73. Kruisselbrink R, Arzola C, Endersby R, et al. Intra- and interrater reliability of ultrasound assessment of gastric volume. Anesthesiology. 2014;121:46–51.

    Article  PubMed  Google Scholar 

  74. Arzola C, Carvalho JC, Cubillos J, et al. Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study. Can J Anaesth. 2013;60:771–9.

    Article  PubMed  Google Scholar 

  75. Moore CL. Ultrasound first, second, and last for vascular access. J Ultrasound Med. 2014;33:1135–42.

    Article  PubMed  Google Scholar 

  76. Costantino TG, Parikh AK, Satz WA, et al. Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access. Ann Emerg Med. 2005;46:456–61.

    Article  PubMed  Google Scholar 

  77. Costantino TG, Kirtz JF, Satz WA. Ultrasound-guided peripheral venous access vs. the external jugular vein as the initial approach to the patient with difficult vascular access. J Emerg Med. 2010;39:462–7.

    Article  PubMed  Google Scholar 

  78. Carvalho B, Cohen SE, Lipman SS, et al. Patient preferences for anesthesia outcomes associated with cesarean delivery. Anesth Analg. 2005;101:1182–7.

    Article  CAS  PubMed  Google Scholar 

  79. Wheeler M, Oderda GM, Ashburn MA, et al. Adverse events associated with postoperative opioid analgesia: a systematic review. J Pain. 2002;3:159–80.

    Article  PubMed  Google Scholar 

  80. Lim Y, Jha S, Sia AT, et al. Morphine for post-caesarean section analgesia: intrathecal, epidural or intravenous? Singap Med J. 2005;46:392–6.

    CAS  Google Scholar 

  81. Gadsden J, Hart S, Santos AC. Post-cesarean delivery analgesia. Anesth Analg. 2005;101:S62–9.

    Article  CAS  PubMed  Google Scholar 

  82. Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after cesarean delivery: a systematic review and meta-analysis. Can J Anaesth. 2012;59:766–78.

    Article  PubMed  Google Scholar 

  83. Paech MJ, McDonnell NJ, Sinha A, et al. A randomised controlled trial of parecoxib, celecoxib and paracetamol as adjuncts to patient-controlled epidural analgesia after caesarean delivery. Anaesth Intensiv Care. 2014;42:15–22.

    Article  CAS  Google Scholar 

  84. Vadivelu N, Gowd AM, Urman RD, et al. Ketorolac tromethamine: routes and clinical implications. Pain Pract. 2014;. doi:https://doi.org/10.1111/papr.12198.

  85. Maund E, McDaid C, Rice S, et al. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine-related side-effects after major surgery: a systematic review. Br J Anaesth. 2011;106:292–7.

    Article  CAS  PubMed  Google Scholar 

  86. Lowder JL, Shackelford DP, Holbert D, et al. A randomized, controlled trial to compare ketorolac tromethamine versus placebo after cesarean section to reduce pain and narcotic usage. Am J Obstet Gynecol. 2003;189:1559–62.

    Article  CAS  PubMed  Google Scholar 

  87. Singh SI, Rehou S, Marmai KL, et al. The efficacy of 2 doses of epidural morphine for postcesarean delivery analgesia: a randomized noninferiority trial. Anesth Analg. 2013;117:677–85.

    Article  CAS  PubMed  Google Scholar 

  88. Loane H, Preston R, Douglas MJ, et al. A randomized controlled trial comparing intrathecal morphine with transversus abdominis plane block for post-cesarean delivery analgesia. Int J Obstet Anesth. 2012;21:112–8.

    Article  CAS  PubMed  Google Scholar 

  89. Costello JF, Moore AR, Wieczorek PM, et al. The transversus abdominis plane block, when used as part of a multimodal regimen inclusive of intrathecal morphine, does not improve analgesia after cesarean delivery. Reg Anesth Pain Med. 2009;34:586–9.

    Article  PubMed  Google Scholar 

  90. ∙ Singh S, Dhir S, Marmai K, et al. Efficacy of ultrasound-guided transversus abdominis plane blocks for post-cesarean delivery analgesia: a double-blind, dose-comparison, placebo-controlled randomized trial. Int J Obstet Anesth. 2013;22:188–93. The primary outcome was that transversus abdominis plane block with high-dose ropivacaine does not reduce pain with movement 24 hours after cesarean delivery compared to low-dose ropivacaine and placebo. The secondary outcomes of pain scores at 6 and 12 hours after cesarean were reduced with high-dose ropivacaine compared to low-dose ropivacaine and placebo.

  91. McKeen DM, George RB, Boyd JC, et al. Transversus abdominis plane block does not improve early or late pain outcomes after Cesarean delivery: a randomized controlled trial. Can J Anaesth. 2014;61:631–40.

    Article  PubMed  Google Scholar 

  92. Williams BA, Bottegal MT, Kentor ML, et al. Rebound pain scores as a function of femoral nerve block duration after anterior cruciate ligament reconstruction: retrospective analysis of a prospective, randomized clinical trial. Reg Anesth Pain Med. 2007;32:186–92.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Kolarczyk LM, Williams BA. Transient heat hyperalgesia during resolution of ropivacaine sciatic nerve block in the rat. Reg Anesth Pain Med. 2011;36:220–4.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. University of Miami Miller School of Medicine-Jackson Memorial Hospital, 1611 NW 12th Avenue, Central 301, Miami, FL, 33136, USA

    Daria M. Moaveni, Jennifer H. Cohn, Zahira D. Zahid & J. Sudharma Ranasinghe

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  1. Daria M. Moaveni
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  2. Jennifer H. Cohn
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  3. Zahira D. Zahid
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  4. J. Sudharma Ranasinghe
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Correspondence to Daria M. Moaveni.

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This article is part of the Topical Collection on Obstetric Anesthesia.

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Moaveni, D.M., Cohn, J.H., Zahid, Z.D. et al. Obstetric Anesthesiologists as Perioperative Physicians: Improving Peripartum Care and Patient Safety. Curr Anesthesiol Rep 5, 65–73 (2015). https://doi.org/10.1007/s40140-014-0094-1

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