Honored to step into the role of President-Elect of @SOAP ! Grateful for the community, people, and mission that make this work matter. Let’s build what’s next—together!

Proud to be Pitt #H2P #OBAnes #SOAPam2025 #MaternalHealth #Anesthesia

Excited. Humbled. Ready.

Let’s go!

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

#ostheimer2025

@emilysharpe.bsky.social’s key take-home points from #Ostheimer25 lecture at #SOAPAM2025:
▪️ #OBAnes makes difference in SMM & GA rates (necessary GA must be done!)
▪️optimize uterotonic dosing +/- calcium
▪️prevent & TREAT pain at caesarean
▪️VL for neonates exists
▪️Digital tech/AI may transform care

Dr Dave Bishop & Prof Rob Dyer make an appearance in #Ostheimer25 discussing readiness of hospitals in Africa for #PPH. Many hospitals lack necessary #OBAnes resources & protocols to manage #PPH during & after caesarean, especially 2nd line uterotonics. #SOAPAM2025

@oaa-anaes.bsky.social guidelines for the management of intrathecal catheter after ADP from Griffiths et al at #SOAPAM2025. Intrathecal catheters can provide excellent anaesthesia, but risk significant drug error & high spinal. Clear guidelines NB. #OBAnes

As is the tradition, @emilysharpe.bsky.social reviewed over 6000 #OBAnes articles from 2024 to create a 177 article syllabus (see QR code above) and presenting 32 in the lecture at #SOAPAM2025. Methods below.

Major themes:

Scan the QR code, you know you want to

Anyone who has followed #OBAnes knows the drill now that Stanford AIM lab provides excellent support for #SOAPAM2025 and the #Ostheimer2025 lecture - access the entire syllabus at Ostheimer.app

@emilysharpe.bsky.social presented the #Ostheimer2025 lecture at #SOAPAM2025 last night and it seems the most fitting opportunity to test BlueSky’s #OBAnes 🧵 capability. @oaa-anaes.bsky.social, a test run for Belfast?

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...