Obstetric Anesthesiology

The Obstetric Anesthesia Division is composed of a very diverse set of core and adjunct faculty Anesthesiologists which is a great asset to take care of our culturally diverse patient population. It is comprised of nine core obstetric (OB) anesthesia fellowship trained (coming from different academic background which brings a wide range of evidenced -based safe anesthesia management practices), and 27 adjunct faculty thus providing 24 /7 coverage.  In addition, we recently introduced, a back-up call coverage to cover for additional complicated obstetric cases posted at nights and weekends either in the main OR’s at the Heart and Vascular Institute (HVI) operating rooms.

We provide obstetric anesthesia services at Memorial Hermann Hospital (MMH) located within the Texas Medical Center (TMC) where there are approximately 4,500 deliveries with 70-80%high risk pregnancies, and at Lyndon B Johnson Hospital (LBJ) with about 2500 deliveries per year, so a total of about 7000 deliveries a year between both sites. The high-risk patients include morbidly adherent placenta (MAP) (the OB/GYN department is applying for certification to be recognized as a Center of excellence for MAP). We also provide care for pregnant patients complicated by cardiac disease, systemic autoimmune disease, bleeding disorders, hypertensive disease, and fetal abnormalities from the fetal center.  Eighty to 85% of the patients receive anesthesia, with a variety of neuraxial techniques such as spinal and/or epidural anesthesia, but also general anesthesia when necessary.

We also staff twice a month a High-Risk Clinic led by one of our OB anesthesia attendings, Dr. Falce, to see our High-Risk parturients and plan adequate anesthesia care ahead of time.

Memorial Hermann Hospital (at TMC) is the main hub for OB anesthesia training for our fellows, residents and Anesthesiology Assistant students. At LBJ we 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. Four residents and two attending anesthesiologists cover the OB floor each day, with one resident, one mid-level and one attending covering the floor each night. Fourth-year medical students are also invited for week-long rotations in obstetric anesthesiology.

We received ACGME certification for our Obstetric Anesthesia Fellowship training in 2020, and were approved for two fellows. Our Fellowship Program Director is Dr. Ana-Lisa Ramirez-Chapman. We have been successful in recruiting excellent fellow candidates from within and outside the institution. 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 as needed). They are a complex part of unique anesthesia management plans due to the rare cases encountered at our institution. They also have access to additional training in Point of Care Ultra Sound (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 such as abstract presentations by fellows, residents and faculty at SOAP and ASA. We received Best Case report and Oral Presentation for prior cases presented at those meetings.

Because we met all the criteria required by the Society of Obstetric Anesthesia and Perinatology (SOAP), in 2022, 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 to improve the standards nationally, and provides a broad surrogate quality metric of institutions providing obstetric anesthesia care. The designation is a result of collaboration across many departments at the Medical School, including the Department of Anesthesiology, Department of Obstetrics, Gynecology, and Reproductive Sciences, and The Women’s Center at Children’s Memorial Hermann Hospital.

Barbara Orlando, MD, PhD, FASA
Chief of Obstetric Anesthesiology
Associate Professor, Department of Anesthesiology
Kendra Brown, MDKendra Brown, MD
Assistant Professor, Department of Anesthesiology
Kristin Falce, MDKristin Falce, MD
Assistant Professor, Department of Anesthesiology
Alice O'Brien, MD
Associate Professor, Department of Anesthesiology
Onyi Onuoha, MD, MPHOnyi Onuoha, MD, MPH
Associate Professor, Department of Anesthesiology
Ramirez-Chapman-Ana-Lisa-web2Ana-Lisa Ramirez-Chapman, MD
Assistant Professor, Department of Anesthesiology
Maya SureshMaya S. Suresh, MBBS
Professor (Tenured),
Vice Chair of Faculty Affairs, Department of Anesthesiology
Mitesh Thakkar, MD
Assistant Professor, Department of Anesthesiology
Danielle White, MD
Assistant Professor, Department of Anesthesiology