Society for Obstetric Anesthesia and Perinatology. Hollywood, Florida. April 26–30, 2006.
The 38th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP) was held April 26–30, 2006, at the Westin Diplomat Resort and Spa in Hollywood, Florida. More than 400 individuals from 18 countries attended the meeting.
The program was in keeping with the society’s mission: to provide anesthesiologists, obstetricians, other physicians, and members of related allied health specialties with knowledge that will reinforce past learning as well as disseminate new concepts, practices, and skills involving anesthesia and analgesia for pregnant women. During the 4 days, the meeting featured the Gertie Marx Award, the Distinguished Service Award, and the Zuspan Award symposia. Other events included the Best Paper Presentations, two pro/con debates, the Fred Hehre Lecture, “Breakfast with the Experts,” and three panel discussions. In addition, participants were exposed to both oral and poster scientific presentations.
On Wednesday, a preconference workshop focusing on High Risk Obstetric Care was held. The program was organized into five topics: Acute Respiratory Failure and Ventilation, Cardiac Arrest in Pregnancy, Anticoagulation and Coagulopathy in Labor and Delivery, Hemodynamic Monitoring, and Hypertensive Crisis. In addition to the Course Directors, 23 faculty members encouraged participants to take active roles in the evaluation of clinical problems, thus developing insights into the skills necessary for diagnosis and resuscitation of high-risk obstetric patients. The day concluded with the SOAP Opening Reception.
The next day opened with the Gertie Marx Symposium. The symposium featured the best abstracts submitted for consideration by resident or fellow anesthesiologists. Results of the Gertie Marx Symposium were as follows: first place, Alexander J. Butwick (Clinical Instructor, Stanford University School of Medicine, Stanford, California), “Effects of Crystalloid and Colloid Preloads on Coagulation Assessed by Thromboelastography in Parturients prior to Elective Cesarean Section”; second place, Shilpa Kasodekar (Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada), “Prophylactic Granisetron Does Not Prevent Nausea and Vomiting during Elective Cesarean Section under Spinal Anesthesia”; third place, Lydia Grondin (OB Fellow, Wake Forest University School of Medicine, Winston-Salem, North Carolina), “Comparison of Loss of Resistance Technique with Air versus Saline to Identify Epidural Space for Combined Spinal Epidural Labor Analgesia.”
After the Gertie Marx symposium, the Distinguished Service Award was presented to Felicity Reynolds, M.D. (St. Thomas’ Hospital, London, England, United Kingdom), recognizing her contributions to the Society and the specialty of obstetric anesthesia.
The first oral scientific presentations, including five works in progress, covering a variety of obstetric anesthesia topics, were presented during the Thursday morning session.
Before the lunch break, society members gathered for the first of two pro/con debates. The first debate was titled “A Non-Particulate Antacid Should Be Used Routinely in All Patients Undergoing Cesarean Section.” Dr. Yaakov Beilin (Associate Professor, Anesthesiology, Associate Professor, Obstetrics, Gynecology and Reproductive, Mount Sinai School of Medicine, New York, New York) presented arguments for using nonparticulate antacids, whereas Dr. Jose Carvalho (Director, Obstetric Anesthesia, Mount Sinai Hospital, Toronto, Associate Professor, Departments of Anesthesia and Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada) presented converse arguments. Beilin described the benefit the treatment would have for a patient experiencing an aspiration event. Conversely, arguments against the routine use of nonparticulate antacids were presented, stating that the side effects of nausea, vomiting, and patient dissatisfaction outweighed the minimum proven benefit of their use. The debate concluded with several members of the audience changing their opinions regarding the routine use of nonparticulate antacids and perhaps opting not to use the treatment in routine cesarean delivery patients.
The afternoon meeting opened with the “What’s New in Obstetrics?” lecture, given by Howard Minkoff, M.D. (Chairman, Obstetrics and Gynecology Residency Program, Maimonides Medical Center, Brooklyn, New York).
After Minkoff’s lecture was the Zuspan Award Symposium. Four participants and their abstracts were introduced. Geraldine O’Sullivan (St. Thomas’ Hospital, London, England, United Kingdom) received the Zuspan Award for his work titled “Does Eating in Labor Influence Obstetric Outcome? A Randomized Controlled Trial in 2400 Primiparous Women” The first meeting day concluded with the Annual Business Meeting. The meeting was called to order, followed by election of officers. Dr. Lawrence Tsen (Director of Anesthesia, Center for Reproductive Medicine, Brigham and Women’s Hospital, Associate Professor in Anesthesia, Harvard Medical School, Boston, Massachusetts) was elected the second vice President of SOAP, with Dr. Brenda Bucklin (Associate Professor of Anesthesiology, University of Colorado Health Sciences Center, Denver, Colorado) being elected the society’s secretary.
Friday began with Oral Presentations #2. Four abstracts were presented. The “Obstetric Medicine Update: Endocrine Disease in Pregnancy” lecture was presented by Dr. Erin Keely (Acting Division Head, Division of Endocrinology and Metabolism, University of Ottawa, Ontario, Canada). This presentation included the description of a number of endocrine abnormalities and the implications on fetal development and delivery. It was an excellent review of both thyroid disease and pheochromocytoma.
After a midmorning break, the first of two poster reviews was presented. A panel discussion titled “Team Training in Obstetrics” followed. Several different techniques associated with the training of teams in the response to crisis events were presented. During the discussion, the anecdotal experiences from a number of institutions were also discussed. One novel aspect of this session was a discussion of the use of simulators on the obstetric ward describing the scheduling of training sessions and their effects.
Saturday began with the traditional forum, “Breakfast with the Experts.” SOAP faculty members held case discussions in a problem-based learning format. Members attended the Gerard W. Ostheimer Lecture, “What’s New in Obstetric Anesthesia,” presented by Roshan Fernando (Head of Obstetric Research Group, Director, Fellowship Program, Consultant in Obstetric Anesthesia, Royal Free Hospital, London, England, United Kingdom). After review of an extensive reference list of more than 800 articles, the 2005 literature relevant to obstetrics and obstetric anesthesia was presented. A second poster review followed.
Next came the Fred Hehre Lecture titled “Lessons Learned from Obstetric Anesthesia.” Dr. David Chestnut (Associate Dean of the Western Clinical Campus, University of Wisconsin School of Medicine and Public Health, La Crosse, Wisconsin) presented an unforgettable synopsis of his career path in the obstetric care of patients. There were a number of clinical pearls and anecdotal events that both educated and emotionally touched the audience.
After lunch came the six Best Papers Presentations. Alison C. Weidner (Division Chief, Urogynecology, Duke University Medical Center, Durham, North Carolina) received the Best Paper Award for her work titled “Neuropathic Injury to the Levator Ani Occurs in 1 in 4 Primiparous Women.”
After the Best Paper Presentations was a panel discussion called “Obstetric Anesthesia and Coexisting Diseases.” The discussion centered on the assessment and management of parturients with coexisting disease states including cardiac disease, coagulopathy, and obesity.
Before the annual SOAP banquet, there was an open forum regarding the proposed revisions to the American Society of Anesthesiologists practice guidelines on obstetric anesthesia. Meeting attendees had the opportunity to comment on a number of aspects of the guidelines and were invited to introduce any new aspect they wanted the task force to review.
Sunday began with a panel titled “Tort Reform.” During this session, the panelists had an opportunity to present some of their experiences, issues, and concerns regarding the process of tort reform. Dr. Andrew Harris (Associate Professor, Department of Anesthesiology/CCM, Johns Hopkins University, Baltimore, Maryland) presented his experiences as an active legislator. This was followed by a pro/con debate called “Supplemental Oxygen Should Be Used Routinely during Cesarean Section.” Dr. Scott Segal (Vice Chairman, Residency Education, Brigham and Women’s Hospital, Boston, Massachusetts) described the benefits of routinely utilizing oxygen, whereas Professor Warwick Ngan Kee (Director of Obstetric Anesthesia and Director of Research, Department of Anesthesia and Intensive Care at the Chinese University of Hong Kong, Hong Kong, China) questioned the merits of routine oxygen. At first, this may seem like a rather easily won debate, with the merits of supplemental oxygen needing no additional support. However, Dr. Kee presented some interesting findings, including information from his own research, leaving members of the audience questioning whether perhaps oxygen should be used routinely. A summary of this debate was published in the SOAP winter newsletter.
The meeting concluded with poster case reports, “You Did What? The Best Case Reports of the Year!”
During the closing ceremonies, members were invited to mark their calendars for the 39th Annual Meeting of SOAP to be held at the Fairmont Banff Springs in Alberta, Canada, May 16–19, 2007.
*Cleveland Clinic, Cleveland, Ohio. smithm1@ccf.org
