The Division of Obstetric Anesthesiology provides anesthetic care for approximately 6,000 patients per year, of which approximately 25 percent are high risk. The labor floor is staffed by a combination of attendings, residents, and fellows. The division is co-chaired by Yaakov Beilin, M.D. and Howard H. Bernstein, M.D.

Approximately 90% of all patients receive labor analgesia. Most women receive either epidural analgesia or the combined epidural-spinal technique. Because Mount Sinai is a tertiary referral center, we care for many high-risk patients including women with cardiac lesions, disorders of coagulation, preeclampsia, abruptio placenta, and placenta previa.

All first-year residents devote one month to the obstetric service. Their clinical work is supplemented with didactic lectures, resident presentations, journal club, and oral examinations. The residents may also devote a block of time, usually three to six months, during their third year for advanced training.

We also offer a fellowship in obstetric anesthesia. Fellows, under the supervision of the attending anesthesiologist, help direct patient care on the labor floor. The fellows are highly encouraged to participate in ongoing research projects and to initiate their own.

Research is expanding at a rapid rate. We have conducted approximately 30 research projects, some have been sponsored by industry and competitive grants. Many of these projects have been presented at national meetings and have culminated in publication in peer-reviewed journals.

1. Epidural vs. combined spinal-epidural technique for labor analgesia: Impact on outcome.
2. User acceptance of CompuRecord on labor and delivery.
3. The effect of degree of labor pain at time of epidural placement on mode of delivery.
4. The evaluation of a new point-of-care platelet function monitor, the PFA-100, in the parturient.
5. The effect of epidural fentanyl on infant breast feeding: A prospective randomized study.
6. A prospective, randomized and double-blind study evaluating three local anesthetics for labor analgesia: bupivacaine vs. ropivacaine vs. levobupivacaine.

1. Zahn J, Bernstein HH, Hossain S, Bodian CA, Beilin Y. Comparison of non-invasive blood pressure measurements on the arm and calf during cesarean delivery. J Clin Monit Comput 2000;16:557-62.
2. Bodian CA, Freedman, G, Hossain S, Eisenkraft JB, Beilin Y. The visual analogue scale for pain: clinical significance in postoperative patients. Anesthesiology 2001;95:1351-6.
3. Beilin Y. Advances in Labor Analgesia. Mt Sinai J Med 2002;69:38-44.
4. Beilin Y, Nair A, Arnold I, Bernstein HH, Zahn J, Hossain S, Bodian CA. A comparison of epidural infusions in the combined spinal/epidural technique for labor analgesia. Anesth Analg 2002,94:927-32.
5. Abramovitz S, Beilin Y. Thrombocytopenia, low molecular weight heparin and obstetric anesthesia. Anesthesiology Clin N Am 2003;21:99-110.
6. Beilin Y, Hossain S, Bodian CA. The numeric rating scale and labor epidural analgesia. Anesth Analg 2003;96:1794-8.
7. Beilin Y, Zahn J, Abramovitz S, Bernstein HH, Hossain S, Bodian CA. Subarachnoid Low Dose Bupivacaine vs. Lidocaine For Cervical Cerclage. Anesth Analg 2003;97:56-61.
8. Beilin Y, Arnold I, Hossain S. Evaluation of the platelet function analyzer (PFA-100#®) vs. the thromboelastogram (TEG) in the parturient. Int J Obstet Anesth 2005;15:7-12.
9. Beilin Y, Bodian CA, Weiser J, Hossain S, Arnold I, Feierman DE, Martin G, Holzman I. Effect of epidural analgesia with and without fentanyl on infant breast-feeding. A prospective, randomized, double-blind study. Anesthesiology 2005;103:1211-17 (Accompanied by an editorial).
10. Beilin Y, Abramovitz S. The anticoagulated parturient. Int Anesthesiol Clin 2007;45:71-81.
11. Torrillo TM, Bronster DJ, Beilin Y. (case report) Delayed diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES) in a parturient with preeclampsia after inadvertent dural puncture. Int J Obstet Anesth 2007;16:171-4.
12. Beilin Y, Guinn NR, Bernstein HH, Zahn J, Hossain S, Bodain CA. Local anesthetics and mode of delivery: bupivacaine vs. ropivacaine vs. levobupivacaine. Anesth Analg 2007;105:756-63.

1. Beilin Y. Labor and Delivery. In: Reed AP and Yudkowitz FS, ed. Clinical cases in anesthesia, 3rd edn. Philadelphia: Elsevier Churchill Livingstone, 2005:347-354.
2. Beilin Y, Telfeyan C. Preeclampsia. In: Reed AP and Yudkowitz FS, ed. Clinical cases in anesthesia, 3rd edn. Philadelphia: Elsevier Churchill Livingstone, 2005:355-362.
3. Bernstein HH, Beilin Y. Abruptio placentae and placenta previa. In: Reed AP and Yudkowitz FS, ed. Clinical cases in anesthesia, 3rd edn. Philadelphia: Elsevier Churchill Livingstone, 2005:363-70.
4. Beilin Y. Anesthesia for nonobstetric surgery during pregnancy. In: Reed AP and Yudkowitz FS, ed. Clinical cases in anesthesia, 3rd edn. Philadelphia: Elsevier Churchill Livingstone, 2005:371-378.
5. Beilin Y, Abramovitz S. Thrombocytopenia in pregnancy. In: Reed AP and Yudkowitz FS, ed. Clinical cases in anesthesia, 3rd edn. Philadelphia: Elsevier Churchill Livingstone, 2005:379-386.
6. Beilin Y. Analgesia During Labor and Delivery. In: Schmidt RF, Willis WD eds. Encyclopedic reference of pain. Berlin: Springer-Verlag Gmbh & Co, 2006, in press.
7. Bernstein HH, You Jerome. Anesthetic considerations for nonobstetric surgery during pregnancy. Advances in Anesthesia 2006, in press.
8. Gist R, Beilin Y. Hypertensive Disorders of pregnancy. In: Wlody D, Gambling D, eds. Practical Approach to Obstetric Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2007, in press.
9. Beilin Y. Anesthesia for cesarean delivery: regional or general? In: Fleisher LA ed. Evidence-Based Practice of Anesthesiology, 2nd edn. Philadelphia: Saunders, 2007, in press.
10. Beilin Y. and Reid RW. Renal disease. In: Chestnut DH ed. Obstetric Anesthesia: Principles and Practice, 4th< edn. Philadelphia: Elsevier Mosby, 2008, in press.

1. Ekwa-Ekoko C, Abramovitz A, Beilin Y, Holzman I, Weiser J, Kavanagh N. Labor epidural fentanyl and newborn breast-feeding. Presented at The Annual Meeting of the Society for Pediatric Research, Boston, MA, May 12, 2000. Abstract: Pediatr Res 2000;47:A187.
2. Zahn J, Arnold I, Hossain S, Bernstein HH, Beilin Y. The Quality of Analgesia When Air Vs. Saline Is Used for Identification of the Epidural Space. Presented at The American Society of Anesthesiologists annual meeting, San Francisco, CA, October 17, 2000. Abstract: Anesthesiology 2000;93:A1100.
3. Zahn J, Bernstein HH, Telfeyan C, Arnold I, Beilin Y. Subarachnoid low dose bupivacaine vs. lidocaine, with fentanyl, for cervical cerclage. Presented an The International Anesthesia Research Society 75th Congress, Ft. Lauderdale, Florida, March 19,2001. Abstract: Anesth Analg 2001;92:S224.
4. Nair A, Arnold I, Bernstein HH, Telfeyan C, Beilin Y. The optimal epidural infusion following the combined spinal epidural technique for labor. Presented at the 33rd Annual Meeting of The Society for Obstetrical Anesthesia and Perinatology, San Diego, California, April 26, 2001. Abstract: Anesthesiology 2001;94:A10.
5. Nair A, Arnold I, Goolie-Scindain J, Bodian CA, Hossain S, Beilin Y. Evaluation of platelet function in the parturient using the platelet function analyzer (PFA-100®). Presented at the 33rd Annual meeting of The Society for Obstetrical Anesthesia and Perinatology, San Diego, California, April 28, 2001. Abstract: Anesthesiology 2001;94:A78.
6. Nair A, Arnold I, Bernstein HH, Zahn J, Beilin Y. The optimal epidural infusion following the combined spinal epidural technique for labor. Presented at The American Society of Anesthesiologists annual meeting, New Orleans, LA, October 15, 2001. Anesthesiology 2001; 95:A1058.
7. Martin G, Beilin Y, Holzman I, Ekwa-Ekoko C, Arnold I, Weiser J. Does maternal epidural fentanyl affect breastfeeding? Presented at the Greater New York Conference on Perinatal Research, November 7, 2002.
8. Beilin Y, Weiser J, Martin G, Bernstein HH, Arnold I, Zahn J, Holzman I. The Effect Of Epidural Anesthesia With And Without Fentanyl On Infant Breast Feeding: A Prospective, Randomized, Double-Blind Study. Presented at the 37th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Palm Desert, CA, May 6, 2005. Abstract: Anesthesiology 2005;102:A52.
9. Beilin Y, Guinn NR, Arnold I, Zahn J, Bernstein HH. Local anesthetics and obstetric outcome: ropivacaine vs. levobupivacaine vs. bupivacaine: A prospective randomized double-blind study. Presented at the 37th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Palm Desert, CA, May 6, 2005. Abstract: Abstract: Anesthesiology 2005;102:A75.
10. Beilin Y, Arnold I, Hossain S. Evaluation of The Platelet Function Analyzer (PFA-100®) vs. the thromboelastogram (TEG) in the Parturient. Presented at the 37th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Palm Desert, CA, May 7, 2005. Abstract: Anesthesiology 2005;102:A48.
11. Torrillo T, Bronster DJ, Beilin Y. Posterior reversible encephalopathy syndrome (PRES): A complicated case of post-partum headache. Presented at the 38th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Hollywood, FL, April 28, 2006. Abstract: Anesthesiology 2006;104:A96.
12. Tumuluri S, Beilin Y. Vaginal Delivery Complicated By Severe Hemorrhage Requiring Recombinant Factor VIIa And Pulmonary Hypertension Necessitating A Right Ventricular Assist Device. Presented at the 39th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, Banff, Canada, May 19, 2007 Abstract: Anesthesiology 2007;106:A242.