Obstetrics Division
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Dr. Ashley Garneau, M.D. guides Resident Tyler Johnson, M.D. in Obstetrics patient care.
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Dr. Mohamed Tiouririne, MD converses with resident Dr. Kelsey Savery, MD about a patient.
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A UVA resident performs a spinal anesthetic on their OB rotation under Dr. Sachin Mehta's (MD) supervision.
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Anesthesiologist Jessica Sheeran, MD heads to see her Obstetrics patient in the OR.
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Dr. Ashley Garneau, MD discusses a case with UVA Dr. Taylor Gilmore, MD.
About
The Obstetrics Division is located within the Anesthesiology Department at the University of Virginia (UVA) Medical Center, a quaternary care center. The obstetric service receives approximately 200 maternal transfers per year from a large catchment area. Currently there are approximately 2,000 deliveries per year at UVA, with a mix of complex high risk and low-risk patients.
The majority of patients presenting in labor choose to receive neuraxial labor analgesia for pain control (epidural and/or spinal analgesia). Non-neuraxial pain control options are also readily available for those patients that desire them, such as nitrous oxide analgesia, patient controlled intravenous analgesia, and truncal nerve block analgesia. Anesthesiology services for obstetric patients are on site 24 hours a day, 7 days a week.
A Message from the Section Chief
Sachin H. Mehta, MD, Section Chief
The Division of Obstetric Anesthesia at the University of Virginia Hospital provides comprehensive, cutting edge care to our obstetric patients. UVA qualifies as a Level IV Regional Perinatal Health Care Center. AT UVA Hospital we provide medical and surgical care for most complex maternal conditions and critically ill pregnant women and fetuses throughout antepartum, intrapartum and postpartum.
UVA is one of the few centers in the region to consistently appear on the Leapfrog Group’s Best Maternity Hospitals list, and is one of only 8 facilities in the state to achieve the Baby-Friendly facility designation.
Our seven obstetric anesthesia faculty consists of individuals with diverse intellectual backgrounds, with a common commitment to optimal care of the pregnant patient. All are board certified anesthesiologists with extensive experience in obstetric anesthesia and genuine dedication to education and innovation. Most members of our division faculty have completed specialized fellowships in Obstetric Anesthesia.
Our Division
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Sachin H. Mehta, MD
Obstetrics,
Cardiothoracic
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Katherine Black, MD
Obstetrics
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Sunny S. Chiao, MD
Obstetrics,
Adult Multi-Specialty
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Ashley W. Garneau, MD
Obstetrics,
Adult Multi-Specialty
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Natalie Pate, MD
Obstetrics,
Adult Multi-Specialty
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Jessica S. Sheeran, MD
Obstetrics,
Adult Multi-Speciality
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Mohamed Tiouririne, MD
Critical Care,
Obstetrics
The obstetric anesthesia division continuously implements and refines specialized programs to enhance and optimize care of the pregnant patient. Some of our initiatives include:
- Enhanced recovery after obstetrical surgery (EROS): Enhanced recovery is a novel approach to improving the experience of patients who are planning to have a cesarean birth. It helps patients recover sooner so they can focus on taking care of themselves and their newborn.
- Obstetric Anesthesia High-Risk Antenatal Clinic: Our division sees high-risk obstetric patients referred by their obstetricians in our Preanesthesia Evaluation and Testing Center. The purpose of this consult visit is to devise a management plan for labor and delivery that is tailored to their comorbidity and obstetric status, and to ensure an optimum outcome for mother and child.
- Placenta Accreta Multidisciplinary Protocol: Treatment of this complex condition, which can result in massive hemorrhage, occurs in our specialized hybrid operating rooms. Team members include maternal fetal medicine specialists, obstetric anesthesiologists, interventional radiologists, gynecologic oncologists, and vascular surgeons.
The Obstetric Anesthesia Division has an accomplished record of impactful clinical research. A representative sample of our research output is listed below.
Bollag L, Lim G, Sultan P, Habib AS, Landau R, Zakowski M, Tiouririne M, Bhambhani S, Carvalho B. “Consensus statement and recommendations for enhanced recovery after Cesarean.” Society for Obstetric Anesthesia and Perinatology, Anish Analg. 2021 May 1;132(5):1362-1377.
Butwick AJ, Tiouririne MJ. “Evaluation of high-risk obstetric patients: a survey of US academic centers.” Clin Anesth. 2016 Sep;33:460-8.
Chiao SS, Sheeran JS. “Extracorporeal membrane oxygenation therapy after amniotic fluid embolism with undetectable ROTEM FIBTEM activity: a case report.” A A Pract. 2020 Nov;14(13):e01349.
Kleiman AM, Sheeran JL, Tiouririne M. “A Case report of Recurrent Severe Peripartum Cardiomyopathy complicated by Factor V Leiden and Multiple Endocrine Neoplasia Type 1: A management conundrum.” A A Pract. 2018 Apr 15;10(8):195-197.
Kleiman, A.M., Tiouririne, M. “Evaluation of the impact of enhanced recovery after surgery protocol implementation on maternal outcomes following elective Cesarean Delivery.” International Journal of Obstetrics Anesthesia, 2020 Aug;43:39-46.
Singla P, Dixon AJ, Sheeran JL, Scalzo D, Mauldin FW Jr, Tiouririne M. “Feasibility of spinal anesthesia placement using automated interpretation of lumbar ultrasound images: a prospective randomized controlled trial.” J Anesth Clin Res. 2019;10(2):878.
Terkawi AS, Tiouririne M, Mehta SH, Hackworth JM, Tsang S, Durieux ME. “Ondansetron does not attenuate hemodynamic changes in patients undergoing elective Cesarean Delivery using Subarachnoid Anesthesia: A double-blind, placebo-controlled, randomized trial.” Reg Anesth Pain Med. 2015 Jul-Aug;40(4):344-8.