Hemodynamic Effects of Spinal Anesthesia in HIV-Positive Pregnant Women
Release Date: 04/23/2026
Cardio-Obstetric Anesthesia at SOAP: Hemodynamics, Monitoring, and Preeclampsia
TopMedTalk
At the SOAP meeting in Montreal, Desiree Chappell and Monty Mythen interview Dr. Marie Louise Meng, Assistant Professor of Anesthesiology at Duke University Department of Anesthesiology and her former cardio-obstetric fellow Liliane Ernst, assistant professor in the Obstetric and Gynecologic Anesthesia section Wake Forest University. The conversation focuses on cardio-obstetric anesthesia, hemodynamics, monitoring, and patient-centered care. Meng describes building multidisciplinary “pregnancy heart teams” to plan management for complex cardiac disease in pregnancy and reduce birth trauma....
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Sir Bruce Keogh on the NHS at 70, TopMedTalk Classics
TopMedTalk
TopMedTalk introduces our new “TopMedTalk Classics” series with a classic TopMedTalk episode from 2018 that is still prescient today. This lecture, given by Sir Bruce Keogh marked the NHS’s 70th birthday, a time framed by political volatility, financial constraint, rising demand, and shifting public expectations. Keogh argues healthcare systems must adapt, highlighting the UK’s strengths in medical science, innovation, life sciences, and the scale and complexity of the NHS. He describes quality improvement efforts since 2008, including defining quality as effectiveness, safety, and...
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AOA Meeting: Shaping AI for Anaesthesia
TopMedTalk
The Association of Anaesthetists meeting in London was the perfect spot for us to launch our new series on Artificial Intelligence. Here, Andy Cumpstey and James Bowness discuss the new monthly series and the UK-Ireland “demand signaling” project on AI in anaesthesia, perioperative medicine and acute pain, supported by The Association. They are joined by their guest Nicky De Beer, The Association’s chief executive. She explains that their members want problems defined in advance before technology solutions are imposed from above. She highlights key clinical themes—enhanced monitoring...
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Perioperative Profile: Vanessa Beavis
TopMedTalk
Settle yourself in for another fascinating glimpse behind the curtain as TopMedTalk’s perioperative profiles focus upon the incredible journey of Vanessa Beavis. Recorded at ANZCA’s recent annual scientific meeting in Auckland, TopMedTalk host Andy Cumpsty interviews anesthetist and former ANZCA President Vanessa Beavis about her path from growing up in South Africa to moving to Auckland in 1993. We discuss her early work in obstetrics, solo general practice, and training in anesthesia before emigrating. She describes becoming involved in departmental leadership, navigating hospital...
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Cardiac Biomarkers and Perioperative Management of Right Ventricular Failure
TopMedTalk
From the World Congress of Anesthesiologists in Marrakech, TopMedTalk hosts Mike Grocott and Kate Leslie discuss perioperative cardiac risk assessment with Hilary Grocott, Professor and Head of, The Department of Anesthesiology, Pharmacology & Therapeutics (University of British Columbia) and Michelle Chew Professor of Anesthesiology and Intensive Care Medicine at Karolinska Institutet, Stockholm, Sweden, and editor for the British Journal of Anaesthesia. The conversation reviews perioperative cardiac biomarkers, noting abundant prognostic data but limited evidence for biomarker-led...
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SOAP: Research Frontiers and Translating Obstetric Anesthesia Evidence to Bedside
TopMedTalk
At the Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, TopMedTalk hosts Desiree Chappell and Mike Grocott interview SOAP board member Dr. Dan Katz, an obstetric anesthesiologist at Mount Sinai, outgoing annual meeting chair and incoming vice president. Katz reports record attendance—over 900 preregistrations and nearly 1,100 total—plus standing-room sessions and review of 600+ abstracts. He highlights opening with research presentations (magnesium and postpartum hemorrhage, gestational thrombocytopenia and hemorrhage, and potential immunotherapies tied to...
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SOAP: Leadership, Population Health, Patient-Centered Obstetric Anesthesia, and Monitoring Innovation with Grace Lim
TopMedTalk
At the 58th Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, TopMedTalk guest host Desiree Chappell and co-editor-in-chief Mike Grocott interview Dr. Grace Lim, SOAP vice president/president-elect and new University of Utah department chair. They discuss her priorities for her upcoming presidency, healthcare’s shifting challenges, highlighting the Frederick W. Hehre Lecture_,_ from Valerie A. Arkoosh about a systems-focused career from obstetric anesthesiology to leading public health roles in Pennsylvania. Lim emphasizes anesthesiologists as systems thinkers...
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WCA: Shared Decision-Making and Communicating Risk for High-Risk Surgical Patients
TopMedTalk
Our coverage of The World Congress of Anesthesiologists (WCA) in Marrakesh continues. Andy Cumpstey and Kate Leslie discuss high-risk surgical patients with anesthesiologists Debra Leung (The Peter MacCallum Cancer Centre, Melbourne) and Duminda Wijeysundera (St. Michael’s Hospital, Toronto). They explore how “high risk” extends beyond mortality (noting ~2% elective major surgery mortality in middle/high-income countries) to complications, medical morbidity, cognitive and functional decline, return to independence, and psychosocial factors such as social support. They describe a...
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ANZCA ASM: Incoming President Dr Tanya Selak and FPM Dean, Prof Michael Veltman
TopMedTalk
At the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine (FPM) held in Auckland, New Zealand, Kate Leslie and Andy Cumpstey interview incoming ANZCA president Tanya Selak and incoming FPM Dean Michael Veltman about their goals in the next two years and the challenges ahead, and their appreciation of the hard work and commitment of fellows and trainees at the coalface. Dr Tanya Selak is a consultant anaesthetist in Woolongong, Australia. Professor Michael Veltman is consultant pain medicine physician in Perth, Australia. --...
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Improving Maternal Safety with Continuous Noninvasive Blood Pressure Monitoring in Obstetrics
TopMedTalk
At the Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, Desiree Chappell and Mike Grocott interview Meghan MacCleary, Obstetrician-Gynaecologist with Banner Health in Phoenix, about multidisciplinary collaboration to improve maternal outcomes. Dr MacCleary describes her high-risk tertiary practice (about 4,000 deliveries/year; 25–26% C-sections) and decision-making for C-section based on safest delivery for mother or baby, amid rising maternal comorbidities, obesity, and older maternal age. She highlights concerns during C-section including patient comfort,...
info_outlineAt the 19th World Congress of the Societies of Anaesthesiologists (WCSA 2026) in Marrakesh, TopMedTalk welcomes Desiree Chappell back alongside Kate Leslie to interview Professor Palesa Motshabi-Chakane, Associate Professor and Head of Anaesthesiology at the University of the Witwatersrand and her colleague, Dr Mullai Slave a PhD candidate at University of the Witwatersrand.
They discuss a study of 629 women undergoing cesarean section with spinal anesthesia at Chris Hani Baragwanath Hospital, where 23–33% are HIV positive.
Using standard monitoring plus BD APM noninvasive continuous hemodynamic monitoring, they compared HIV-positive and HIV-negative patients and found higher hypotension incidence in HIV-positive women (68% vs 64%), with lower heart rate and lower cardiac index over 60 minutes.
Additional testing included echocardiography with speckle tracking, pro-BNP, and autonomic assessments, with HIV-positive patients showing stiffer ventricles; Apgar scores did not differ. They discuss replication, multicenter research, and potential machine-learning tools to predict hypotension risk, and describe BD Advanced Patient Monitoring grant support enabling equipment, sensors, staffing, and training (~200 staff) to complete data collection in about six months.
Edwards Lifesciences is now known as Becton Dickinson Advanced Patient Monitoring (BD APM).
Desiree Chappell, former Co Editor in Chief of TopMedTalk, is now Director, Medical Science Liaison, Medical Affairs, BD Advanced Patient Monitoring. The views expressed on this program are her own and not those of her employers.
We mention Adrian Gelb, if you’d like to hear his recent conversation with us go here: https://topmedtalk.libsyn.com/professor-adrian-gelb-on-patient-safety-and-essential-medicines-in-anaesthesia
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