Obstetric Anesthesia Research and Innovation

Research

Given our partnership with Stanford Medicine, we are able to implement findings from our obstetric anesthesiology research into clinical practice quickly, bringing you the latest proven innovations for pain control and obstetric anesthesiology.

Our Stanford Medicine physician-scientists are advancing maternal-fetal medicine, as well as obstetric, obstetric anesthesia, and neonatal care with an outstanding record of excellence in clinical investigation, patient-oriented research (clinical trials), evidence-based research, and disease-targeted research. We are one of the leading research obstetric anesthesiology groups in the world. Our research aims to identify the best pain relief options for labor and cesarean section, optimal anesthesia for patients with high-risk conditions, ways to improve recovery after cesarean section, ways to determine predictors of and optimally manage obstetric hemorrhage, and how pregnancy affects drug dose requirements. Our research and protocols have contributed significantly to the field of obstetric anesthesiology by influencing national guidelines on high-quality clinical care.

Research highlights include the following:

• Discovering ways to address the full range of disorders that may occur in the mother and fetus during pregnancy and advancing maternal-fetal medicine, as well as obstetric, obstetric anesthesia, and neonatal care.
• Creating a unique Obstetric Simulation Program and the world’s first simulated delivery room at the Center for Advanced Pediatric and Perinatal Education (CAPE) at Stanford Children’s Health. Multidisciplinary obstetric simulations are regularly carried out in the labor and delivery unit covering different clinical scenarios so that we are fully prepared for even the most rare and complex clinical situations. We learn together as a team so that we can work seamlessly with one another in a crisis.
• Participating in several quality care initiatives to improve maternal and newborn care. For example, we have participated in the development of the California Maternal Quality Care Collaborative’s (CMQCC) recommendations and tool kits for obstetric hemorrhage, preeclampsia, and maternal sepsis. As part of the CMQCC, we contribute to data on neonatal intensive care units across California, giving us opportunities to assess prenatal, neonatal, and postnatal care.
• Ensuring high-risk infant care through our partnership with California Children’s Services to administer the statewide High-Risk Infant Follow-Up Quality Care Initiative.

Innovations

We are way ahead of the curve on the latest pain control options and techniques. Examples of recent innovations include the following:

• Offering nonstandard labor pain options that are unavailable at most hospitals, including nitrous oxide, which is popular in Europe and in a few select birthing centers in the United States. Some women choose to use nitrous oxide instead of other forms of pain relief. For women who are unable to receive an epidural due to medical conditions, we offer nitrous oxide or a potent, baby-friendly narcotic (e.g., remifentanil), which requires expert monitoring and care.
• Providing leading-edge management for women who may experience unexpected bleeding after delivery (which occurs in approximately three to four out of every 100 births). We have access to advanced measurement tools to assess blood clotting issues that may develop during bleeding events. We are able to administer lifesaving blood clotting and other blood products—for example, fibrinogen, which is available in only a few hospitals worldwide.
• Using a point-of-care ultrasound to examine the heart and lungs to help with crisis care to ensure safe management if the unexpected occurs. We are trained and ready to use this superior technology.
• Employing ultrasound to assist with IV cannulation and regional block placement (if necessary) to reduce discomfort with placement and improve the safety of care.
• Preparing epidural and spinal medications in our Stanford Children’s Health pharmacy, which decreases the chance of a drug error and saves time when we are preparing to perform the spinal or epidural procedure.
• Using low concentrations of medications (ultralight epidurals) and specialized epidural administration techniques to avoid excessive numbness, which enables you to push effectively during delivery.
• Encouraging women to select the amount of pain medication during and after a cesarean section to allow patient-centered care and provide the appropriate pain relief while reducing side effects.

Clinical studies

Our clinical research studies have resulted in many advances in obstetric anesthesiology and improvements in the safety of pain relief techniques. When a clinical study is in progress and you qualify, we will explain the study to you and ask if you would like to participate.