Emily Sharpe, MD, FASA

It was a privilege to give grand rounds at Advocate Illinois Masonic Medical Center last week in Chicago. I presented “What’s New in #OBAnes “

I enjoyed catching up with friends and making new connections. Thank you for the invitation and the hospitality! #Ostheimer2025

Such an honor to give Grand Rounds at Brigham & Woman’s Hospital (MGB) this past week. Loved reconnecting with my #OBAnes friends and meeting new ones. Thanks for the invitation!
#Ostheimer2025

The complete 2025 Gerard W. Ostheimer Lecture “What’s new in #OBAnes?” from #SOAPAM2025 as presented by @emilysharpe.bsky.social

#ostheimer2025

Thank you!

Wearable technology may provide a digital biomarker for preterm delivery by screening for changes in nighttime maternal heart rate variability throughout pregnancy.

#Ostheimer2025 #OBAnes #SOAPAM2025
journals.plos.org/plosone/arti...

🩺 AI-guided screening using a digital stethoscope doubled diagnosis of pregnancy-related cardiomyopathy vs usual obstetric care
🩺 Identified 🤰 who may have remained undiagnosed

#SOAPAM2025 #OBAnes #Ostheimer2025

www.nature.com/articles/s41...

RCT compared first pass success of VL vs DL in neonates:
✅ Video laryngoscopy increases the success rate for first-attempt intubation.
✅ NRP should be updated to include recommendations for VL for intubation

#Ostheimer2025 #OBAnes #SOAPAM2025
www.nejm.org/doi/full/10....

This model incorporating SSDOH variables performed as well as models including race, demonstrating that SSDOH can likely be used in other clinical algorithms in place of race or ethnicity.

#SOAPAM2025 #Ostheimer2025 #OBAnes
www.ajog.org/article/S000...

Ende et al successfully developed & validated a PPH prediction model that outperformed the CMQCC tool
✅ Model has potential for improving clinical care by providing accurate & timely risk assessments

#SOAPAM2025 #Ostheimer2025 #OBAnes

journals.lww.com/greenjournal...

Systematic review & individual pt data meta-analysis of >55,000 pts
✅ TXA reduces risk of life-threatening postpartum hemorrhage
✅ No increased risk of thrombosis
✅ Data do not support TXA to all to prevent PPH
#Ostheimer2025 #OBAnes #SOAPAM2025
www.sciencedirect.com/science/arti...

Study compared residual gastric volumes in fasted vs ‘Sip Til Send’ with water liberal drinking protocol.
‘Sip Til Send’ was noninferior to fully fasting in in terms of the antral CSA.
#SOAPAM2025 #Ostheimer2025 #OBAnes
journals.lww.com/ejanaesthesi...

Observational study that evaluated incidence of patient-reported intraoperative pain:
✅ 12 percent of patients reported pain
✅ Mismatch between reported pain and supplemental analgesia administration

#SOAPAM2025 #OBAnes #Ostheimer2025
www.sciencedirect.com/science/arti...

RCT methergonovine vs carboprost:
✅ No difference detected in uterine tone score 10 minutes after administration of methylergonovine maleate or carboprost tromethamine as second-line uterotonic

#OBAnes #Ostheimer2025 #SOAPAM2025

journals.lww.com/greenjournal...

👉 People with twin pregnancy require a 10x higher loading dose of oxytocin than those with singleton pregnancies,
👉 Consider an initial 5 IU bolus at elective CD under neuraxial anesthesia.

#Ostheimer2025 #SOAPAM2025 #OBAnes
journals.lww.com/anesthesia-a...

🔵 Dose-finding study to determine ED90 of oxytocin infusion to maintain tone after an initial 1 IU oxytocin bolus

🔵 Maintenance infusion of 4.5 units/hour provides continued uterine tone in scheduled CD

#SOAPAM2025 #Ostheimer2025 #OBAnes
link.springer.com/article/10.1...

RCT of IV Calcium chloride vs placebo demonstrated:
✅ IV calcium was well tolerated
✅ may reduce blood loss during intrapartum cesarean delivery with uterine atony

#SOAPAM2025 #OBAnes #Ostheimer2025
journals.lww.com/greenjournal...

🤰 This multidisciplinary consensus statement provides practical and concise clinical guidance to optimize pain management for pregnant people with OUD to improve maternal and perinatal outcomes

#SOAPAM2025 #Ostheimer2025 #OBAnes
journals.lww.com/anesthesia-a...

✅ Intrathecal catheters can provide excellent labor analgesia & CD anesthesia
✅ Significant drug errors may result in high-spinal
✅ Clear guidelines needed on the use of IT catheters

#SOAPAM2025 #Ostheimer2025 #OBAnes
associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10....

Ansari et al evaluated anesthetic management for postpartum tubal ligation
✅ Labor epidural catheter reactivation failure rates was 35%
✅De novo spinal anesthesia failed in 15% of PPTLs.

#SOAPAM2025 #Ostheimer2025 #OBAnes
www.obstetanesthesia.com/article/S095...

Can you perform DPE with 27g?

✅ DPE with a 27g spinal needle had higher incidence of sacral blockade than epidural within an hour after placement.
✅ Time to adequate analgesia did not differ

#SOAPAM2025 #Ostheimer2025 #OBAnes
www.obstetanesthesia.com/article/S095...

Labor #epidural analgesia was associated with a 35% reduction in severe maternal morbidity and particularly noticeable among women at increased risk

@bmj_latest #SOAPAM2025 #Ostheimer2025 #OBAnes
www.bmj.com/content/385/...

The NIH Pathways to Prevention panel on postpartum health provides a consensus statement on the evidence, research gaps, and future priorities to prevent maternal morbidity and mortality.

#SOAPAM2025 #Ostheimer2025 #OBAnes
pubmed.ncbi.nlm.nih.gov/38128099/

👉 Joseph et al conclude recent changes in maternal mortality surveillance, such as using pregnancy checkbox on death certificates, have led to an overestimation of maternal mortality in US
#SOAPAM2025 #Ostheimer2025 #OBAnes
www.ajog.org/article/S000...

‼️ Even when accounting for familial factors, women w/ perinatal depression were associated with an increased risk of death, particularly during the first year after diagnosis and because of suicide.

#OBAnes #SOAPAM2025 #Ostheimer2025 @bmj_latest

www.bmj.com/content/384/...

👉 The overall MMR declined but maternal suicides did not and are now leading cause of maternal mortality
👉 Need for surveillance & suicide prevention strategies entire 1st year postpartum
@BJOGTweets #SOAPAM2025 #Ostheimer2025 #OBAnes
obgyn.onlinelibrary.wiley.com/doi/10.1111/...

High neuraxial block in the Netherlands in @iarsjournals.bsky.social
✅ Incidence of high neuraxial block was low
✅ Spinal anesthesia after epidural analgesia in labor is a common cause of high neuraxial block.
#SOAPAM2025 #OBAnes #Ostheimer2025

journals.lww.com/anesthesia-a...

NAP7 in #OBAnes:
✅ Hemorrhage single leading cause of periop cardiac arrest
✅ Cardiac arrest is recognized complication of spinal anes
✅ High block develop s/p spinal after failed epidural

#SOAPAM2025 #Ostheimer2025
associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10....

I reviewed >6000 articles ➡️ 177 in syllabus & 32 in lecture.

The major topics came together for me in themes:
✅ Maternal Morbidity & Mortality
✅ Labor analgesia
✅ Cesarean delivery
✅ Hemorrhage
✅ Maternal disparities
✅ Neonatal outcomes
✅ Innovation
#Ostheimer2025 #SOAPAM2025

Thank you @stanfordaimlab for your support of the #Ostheimer2025 lecture. Download the app at Ostheimer.app for access to the entire syllabus.
#SOAPAM2025

Time for the #Ostheimer2025 lecture. I will summarize a few relevant articles published in 2024 for #OBAnes
Thank you to the SOAP board of directors for selecting me for this opportunity.
#SOAPAM2025