Pamela Angle
Associate Scientist, Staff Anesthesiologist
Clinical Trials • Education Research • Health system and quality improvement • Obstetrics and Gyneacology • Translational Science
The Obstetric Anesthesia Research Unit (OARU) is the first research unit in Canada specifically dedicated to the generation of knowledge and the dissemination and transfer of evidence-based clinical practices in obstetrical anesthesia.
OARU was established in 2005 as part of Women’s College Research Institute, under the direction of Dr. Jean Kronberg, former anesthetist-in-chief at Women’s College Hospital. It was founded by clinicians and researchers from the department of anesthesia at Women’s College Hospital and Sunnybrook Health Sciences Centre.
The unit is now affiliated with the University of Toronto and Sunnybrook Research Institute, located at the Bayview Campus of Sunnybrook Health Sciences Centre.
OARU’s mission is threefold:
- to generate high-quality research evidence using appropriate clinical research methodologies;
- to use this knowledge to build models of evidence-based care and transfer this knowledge into clinical practice; and
- to teach research methods/principles of evidence-based medicine as part of building research capacity within obstetric anesthesia.
Director: Dr. Pamela Angle
Projects
Developing a tool to reduce the psychological impact of cesarean sections on women
Urgent and emergency cesarean sections (CS) represent an important source of psychological trauma amongst women and are associated with a fear of future childbirth, postpartum depression, and development of post-traumatic stress disorder (PTSD). An improved understanding of the factors which contribute to a negative birth experience and factors which women find helpful/believe necessary to support them during urgent/emergency CS is required.
Our mixed-methods study explored/described women’s perspectives of urgent/emergency cesarean delivery using qualitative descriptive methods to develop a new Interdisciplinary Patient Support Tool (IPST). The IPST will be used to help guide the supportive care provided by the interdisciplinary team during each stage of cesarean delivery (i.e., immediately preoperatively, during cesarean section, immediately postoperatively).
Principal Investigator:
Sunnybrook Health Sciences Centre
Principal Investigator:
AFP Innovation Fund, $54,685
Novel Diagnostic Pathway for PDPH
Most of the 4.3 million women who give birth in the United States and Canada each year receive epidural analgesia or anesthesia as part of their labor and delivery care. Post-dural puncture headache (“post-epidural PDPH”) represents the most common, important morbidity of epidural needle placement and results from puncture of the spinal sac during epidural needle insertion. However, significant issues exist with diagnosis of PDPH after epidural needle insertions (i.e., “post-epidural PDPH”) which have yet to be formally recognized and addressed. Although formal diagnostic criteria exist for PDPH, these were developed for use after deliberate dural puncture with fine spinal needles and do not account for important differences in epidural needle use and methods of insertion which complicate and confound diagnosis of post-epidural PDPH. New strategies and methods of diagnosis are required to further advance the care of patients with post-epidural PDPH. We are currently developing novel diagnostic tests and a bedside diagnostic pathway for post-epidural PDPH.
Principal Investigator:
Sunnybrook Health Sciences Centre
Funding:
Langar Foundation
Labour Pain Scale
The Angle Labor Pain Questionnaire (A-LPQ) is the first multidimensional psychometric instrument developed specifically to reflect women’s pain experiences during childbirth. Our previous work, which involved three validation studies conducted at Sunnybrook Health Sciences Centre, has demonstrated that the A-LPQ and its five subscales have high levels of internal consistency, test-retest reliability, sensitivity to change and responsiveness during early active labor. Despite this, additional questions remain related to the A-LPQ’s properties and performance which must be addressed.
Investigators:
Dr. Pamela Angle
Sunnybrook Health Sciences Centre
Funding:
Langar Foundation
Research Methods Teaching Series
The Obstetrical Anesthesia Research Unit (OARU) offers formal and informal teaching related to clinical research methodology and clinical appraisal. This is open to anesthesia staff, as well as research and clinical fellows and residents from the University of Toronto during their training. Learning also occurs through participation in OARU’s ongoing research projects. In addition, participants are encouraged to attend formal research rounds organized through the U of T at the Hospital for Sick Children.
As part of this program, OARU provides the opportunity for interdisciplinary learning via the research methods teaching series.
Events
Recent Talks:
- Angle P. Understanding the Stressors Women Experience during Urgent/Emergent CS: An Interdisciplinary Approach. Presented to Women’s and Babies Program Leaders, Sunnybrook Health Sciences Centre, Toronto, ON, December 12, 2023
- Angle P. Possible Solutions to Stressors Women Experience during Urgent/Emergent CS: Building Consensus. Presented to Women’s and Babies Program Leaders, Sunnybrook Health Sciences Centre, Toronto, ON, January 9, 2024
Conferences/Workshop Presentations:
- Angle P, Lay C, Kiss A, Silva M, Kong J, van Der Vyver M. Diagnostic cohort study comparing the accuracy of PDPH Trial criteria vs International Headache Society criteria for post-epidural PDPH. Obstetric Anesthetists’ Association (OAA) Annual Scientific Meeting 2024. Birmingham, England, UK, May 9-10, 2024
- Angle P, Kurtz-Landy C, Barrieau G, Berndl A, Osepchook C, Fleming K. Women’s experiences of anesthesia care during urgent or emergent cesarean section: a qualitative study examining stressors and potential solutions. Obstetric Anesthetists’ Association (OAA) Annual Scientific Meeting 2024. Birmingham, England, UK, May 9-10, 2024 (Felicity Reynolds Prize Competition, accepted for oral presentation)
- Barrieau G, Angle P, Kurtz-Landy C, Berndl A, Osepchook C, Fleming K. Women’s experiences of urgent/emergent cesarean section (UE-CS): A qualitative study, in a patient-centric approach, examining stressors and possible interventions to improve the childbirth experience. Canadian National Perinatal Research Meeting, Vancouver BC, June 3-6, 2024
- Kurtz-Landy C, Angle P, Barrieau G, Berndl A, Osepchook C, Fleming K. Exploring women’s experiences of preterm urgent/emergent Caesarean Section (UE-CS): A qualitative study examining stressors and potential interventions to mitigate negative emotional/psychological impact. Canadian National Perinatal Research Meeting, Vancouver BC, June 3-6, 2024
- Pardy B, Angle P, Lay C, Gawel M, Kiss A, Kong J, van Der Vyver, Roberts L, Hussain K, Halpern S. Diagnostic cohort study comparing the accuracy of PDPH trial criteria vs International Headache Society criteria for post-epidural PDPH. University of Toronto Shields Research Day, Toronto ON, May 4, 2024
- Sharma I, Angle P, Kurtz-Landy C, Barrieau G, Pardy B, Berndl A, Osepchook C, Fleming K, Sarbia M, Prescod A. Women’s experiences of anesthesis care during urgent or emergent cesarean section: A qualitative study examining stressors and potential solutions. University of Toronto Shields Research Day, Toronto ON, May 4, 2024
There are no upcoming events at this time.
Related Links
- Sunnybrook Health Sciences Centre, Division of Obstetrical Anesthesia
- University of Toronto, Department of Anesthesia
Director
Dr. Pamela Angle
Research Staff
Brooke Pardy
Clinical Research Coordinator
Alexandria Au
Research Assistant
Elma Mallick
Research Assistant
Visiting professor
Sunnybrook Foundation has committed to the establishment of a permanent chair in obstetrical anesthesia, which will be an Obstetric Anesthesia Research Unit appointment. Please contact Sunnybrook Foundation to make donations to the chair in obstetrical anesthesia.
Contact
Obstetrical Anesthesia Research Unit
Phone: 416-480-6100 ext. 687757