Obstetric Anesthesiology
The Obstetric Anesthesia Division is composed of a very diverse set of eight core obstetric (OB) fellowship trained, and 31 adjunct faculty anesthesiologists, which are a great asset to take care of our culturally diverse patient population 24/7.
We provide obstetric anesthesia services for about 8000 deliveries a year between 2 sites: the Women’s Center at Children’s Memorial Hermann Hospital located within the Texas Medical Center (TMC) with 5400-5500 deliveries and a large majority of high-risk pregnancies, and Lyndon B Johnson Hospital (LBJ) with 2500 deliveries. Dr. Onyi Onuoha is the site director for the Hermann site. She trained at the University of Pennsylvania for her residency and fellowship. She is also currently one of the Assistant Residency Program Directors. Dr. Alice Lam O’Brien is the site director at LBJ. She trained at Baylor College of Medicine for her residency and fellowship. She is also the Director of Perioperative Informatics for our department.
The high-risk patients include morbidly adherent placenta (MAP), parturient with cardiac disease, systemic autoimmune disease, bleeding disorders, hypertensive disease, and fetal abnormalities from the fetal center. Eighty to 85% of the patients receive anesthesia care. We see those high-risk patients in our OB anesthesia clinic (led by one of our OB core faculty Dr Falce), every month.
The Women’s Center at Children’s Memorial Hermann Hospital is the main hub for OB anesthesia training for our fellows, residents and anesthesiology assistant students. At LBJ we also provide training for our residents, SRNA-DNP students and fellows. Residents begin their training in OB anesthesia in their first clinical anesthesia year (CA-1), with an initial emphasis on basic regional techniques for our large population of laboring patients. In addition, residents are trained to manage a great number of high risk maternal-fetal pregnant patients.
We received ACGME certification for our Obstetric Anesthesia Fellowship training in 2020 and were approved for two fellows. Our Fellowship Program Director is Dr. Kristin Falce who trained at UT Houston for residency and Baylor College of Medicine for her fellowship.
Our fellows are exposed to a large variety of high-risk obstetric cases and have the opportunity to experience multi-disciplinary team approaches in very different locations such as the main operating room or HVI (where we also work closely with the anesthesia cardiac team). They also have access to additional training in Point of Care Ultrasound (POCUS), Maternal and Fetal Medicine, Neonatal Intensive Care Unit, Fetal Center cases and other elective rotations, including emphasis on Clinical research and other scholarly activities.
In 2021, our UTH Obstetric anesthesia division at MHH was awarded accreditation as a SOAP Center of Excellence. SOAP recognizes institutions and programs that demonstrate excellence in obstetric anesthesia care. It sets a benchmark level of expected care
Fellowship
The Department of Anesthesiology, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), has received initial accreditation from the Accreditation Council for Graduate Medical Education (ACGME) for an Obstetric Anesthesia Fellowship Program. The UTHealth System and McGovern Medical School are located in the Texas Medical Center (TMC)—the world’s largest medical complex—and offer invaluable opportunities for an obstetric anesthesia fellow to further their training.
We are currently seeking qualified fellowship applicants to fill two approved positions.
If you are interested, please contact Dr. Kristin Falce, MD, Director of the Obstetric Anesthesia Fellowship Program at [email protected]
Maternal mortality has been steadily on the rise since the late 20th century. Increasing cases of cardiovascular disease, including congenital heart disease, cardiomyopathy, and congestive heart failure, are the leading cause of maternal mortality in Western countries1. Memorial Hermann Hospital—TMC, our primary private hospital, has approximately about 8,000 deliveries/year (mostly insured patients), and Harris Health System’s Lyndon B. Johnson Hospital, our county hospital, has around 2,500 deliveries/year. Between the two clinical locations more than 60% are high-risk parturients. Recently, our obstetric service received accreditation as a Level IV—the highest level of maternal care—which requires a, “Board-certified anesthesiologist with obstetric anesthesia fellowship training or experience in obstetric anesthesia physically present at all times2.” The future is an integrated obstetric critical care team with participation from obstetric anesthesiologists. Currently our division encompasses 8 OB anesthesia trained physicians.
We have multiple faculty who are skilled anesthesiologists and intensivists prepared to train our fellows in Point-of-Care ultrasound-TEE; regional anesthesia techniques; and a state-of-the-art acute pain service. There are also exciting opportunities to participate in simulation, fetal center cases, and to collaborate with the Maternal Fetal Medicine team in safety rounds, and a variety of multidisciplinary meetings, conferences, and joint research.
Under the leadership of the department chairman, Dr. Holger K. Eltzschig, MD, PhD, a preeminent researcher in organ injury and perioperative medicine, we also have an ongoing vibrant and cutting edge perioperative research program to study acute kidney injury in pregnant women. Additionally, there are several clinical research projects under development. Dr. Maya Suresh, MD, former President of the Society for Obstetric Anesthesia and Perinatology (SOAP), former President of the Society for Airway Management and lead editor of Shnider and Levinson Anesthesia for Obstetrics, 5th edition spearheaded the creation of the fellowship program and the accreditation of our division as a SOAP Center of Excellence. Our Division Chief of Obstetric Anesthesia Dr Barbara Orlando, MD, PhD, is continuing the effort initiated by Dr Suresh to increase research involvement and participation in various efforts including maternal safety. Division Chief of Obstetric Anesthesia is part of the fellowship program. Our fellows can anticipate completing their year of training with not only a rich body of experience to enhance their armamentarium of clinical and research skills, knowledge, and confidence needed while caring for any high risk or critically ill obstetric patient, but also opportunities to participate in ongoing research and to present at national conferences.
 | Barbara Orlando, MD, PhD, FASA Chief of Obstetric Anesthesiology Associate Professor Adjunct Associate Professor - Obstetrics, Gynecology and Reproductive Sciences |
 | Alice O'Brien, MD Site Director at Lyndon B Johnson Hospital and Director of Perioperative Informatics Associate Professor Adjunct Associate Professor - Obstetrics, Gynecology and Reproductive Sciences |
 | Onyi Onuoha, MD, MPH Site Director Women's Center at Children's Memorial Hermann Hospital and Assistant Residency Program Director Associate Professor Adjunct Associate Professor - Obstetrics, Gynecology and Reproductive Sciences |
 | Kristin Falce, MD Obstetric Anesthesiology Fellowship Director Assistant Professor |
 | Shonna Gaskin, MD Assistant Professor |
 | David Hundley, DO Assistant Professor |
 | Maya S. Suresh, MBBS Honorary Professor, Vice Chair of Faculty Affairs |
 | Mitesh Thakkar, MD Assistant Professor |
 | Danielle White, MD Assistant Professor |