Delivering Under Pressure

Season 1 of Delivering Under Pressure: Ob Anesthesia 101

Do you practice obstetric anesthesia? Are you looking for free, practical, and easy-to-access information to help manage acute medical and obstetric emergencies—or navigate high-risk scenarios during labor and delivery? Then you’re in the right place. Hosted by Dr. Alex Butwick (Obstetric Anesthesiologist at UCSF) and a team of experienced co-hosts, this podcast walks you through some of the most complex, high-stakes moments in obstetric anesthesia. Each episode breaks down challenging clinical situations, offering expert insights and real-world strategies that are relevant for everyone—from trainees to seasoned attending anesthesiologists. Subscribe now and stay tuned—more episodes are on the way!

Episode 2: High Stakes and Low Platelets – Managing HELLP Syndrome in the OR

In this episode, we walk through the anesthetic management of a pregnant patient with HELLP syndrome who requires an urgent cesarean delivery. With neuraxial anesthesia off the table, we focus on the critical aspects of delivering safe and effective general anesthesia in a high-risk maternal patient. From airway planning and induction strategies to hemodynamic management and coordination with obstetric and ICU teams, this case-based discussion offers real-time insights for navigating one of the most complex emergencies in obstetric anesthesia. The show hosts are Dr. Alexander Butwick MBBS, FRCA, MS - Professor of Anesthesia and Division Chief of Obstetric Anesthesia in the Department of Anesthesia & Perioperative Care at University of California San Francisco, Dr. Amanpreet Bilg MD - Resident in Anesthesia, Department of Anesthesia & Perioperative Care at University of California San Francisco, and Chioma Onuoha - MD Candidate 2025, University of California, 2025. The views expressed by the hosts are based on individual experience and content knowledge and do not reflect those of the University of California San Francisco.

Episode 1: Postpartum Hemorrhage: The Anesthesiologist’s Role When Seconds Count

In this kickoff episode, we dive into one of the most critical emergencies in obstetric care: postpartum hemorrhage (PPH). Focused on practical, real-time management, we break down how obstetric anesthesiologists respond to acute bleeding—starting with uterine atony, the leading cause of PPH. We cover the pharmacologic toolkit for uterine tone, strategies for transfusion, and the anesthesiologist’s role in coordinating multidisciplinary care when every second matters. Whether you're a trainee or seasoned clinician, this episode delivers clinical pearls and structured approaches you can apply at the bedside. The show hosts are Dr. Alexander Butwick MBBS, FRCA, MS - Professor of Anesthesia and Division Chief of Obstetric Anesthesia in the Department of Anesthesia & Perioperative Care at University of California San Francisco, Dr. Amanpreet Bilg MD - Resident in Anesthesia, Department of Anesthesia & Perioperative Care at University of California San Francisco, and Chioma Onuoha - MD Candidate 2025, University of California, 2025. The views expressed by the hosts are based on individual experience and content knowledge and do not reflect those of the University of California San Francisco.