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 Division Chief
Sachin H. Mehta, M.D., Division 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
Sachin H. Mehta, MD
Sachin H. Mehta, MD, Obstetrics Division Chief
Dr. Mehta was born and raised in central New Jersey, and received a BA in Government from Dartmouth College, graduating summa cum laude. He attended medical school at the University of Pennsylvania, and trained in anesthesiology at the University of California at San Diego. He pursued additional subspecialty training in obstetric anesthesia at Stanford University Medical Center, and cardiac anesthesia at the University of Virginia.
Dr. Mehta serves as Division Chief of Obstetric Anesthesia at the University of Virginia, and as a senior editor on the American Board of Anesthesiology advanced examination committee. He is an Associate Professor of Anesthesiology. His clinical and academic interests include obstetric anesthesia, transesophageal echocardiography, and cardiac anesthesia.
Katherine Black, MD
Katherine Black, MD
Dr. Black attended the University of Nebraska-Lincoln where she graduated with high distinction with a degree in Biological Sciences and was elected to Phi Beta Kappa. She received her medical degree from the University of Nebraska College of Medicine in Omaha where she graduated with distinction and was elected to the Alpha Omega Alpha medical honor society.
Dr. Black completed her anesthesia residency at the University of Virginia in 2011. Her areas of interest include obstetric anesthesia, general anesthesia, and ambulatory anesthesia.
Sunny S. Chiao, MD
Sunny S. Chiao, MD
Dr. Sunny Chiao is a board-certified anesthesiologist. Her clinical practice includes general anesthesiology and obstetric anesthesiology. She grew up in Northern Virginia, and completed her undergraduate degree in Biology at the University of Virginia. She received her medical degree from the University of Virginia School of Medicine.
Dr. Chiao completed residency training in Anesthesiology also at UVA, and went on to pursue fellowship training in Patient Safety and Quality Improvement, after which time she joined the UVA faculty. Dr. Chiao has research interests in quality improvement, perioperative informatics, and medical education. In her free time, she has a passion for spending time with her family, traveling, and rescue animals.
Ashley W Garneau, MD
Ashley W Garneau, MD
Dr. Ashley Garneau is an Assistant Professor of Anesthesiology in the Department of Anesthesiology at the University of Virginia. She specializes in the anesthetic care of high-risk obstetric patients, both on the labor floor and in the operating room. She completed an Obstetric Anesthesia Fellowship at Mount Sinai Hospital.
Her academic interests include ameliorating healthcare disparities, enhanced recovery after cesarean and vaginal delivery, and facilitating improved education and preparedness through guided medical simulation. She is an active member of the Society for Obstetric Anesthesia and Perinatology.
Amanda M. Kleiman, MD
Amanda M. Kleiman, MD
Dr. Kleiman is an Associate Professor of Anesthesiology at the University of Virginia. Her clinical interest/focus centers on caring for patients undergoing cardiothoracic and major vascular surgery as well as liver transplantation. Her research interests include improvement of the care of cardiothoracic surgical patients, echocardiography, and education research focusing on maximizing the quality of resident and medical student education.
Dr. Kleiman has grant funded research examining sleep disturbance following cardiac surgery and its relationship to delirium and dementia. Her particular education research interests include biases in education, the effect of stress, sleep, and wellness on resident training, and novel education/learning techniques. Outside of work, she enjoys being outside with her friends and golden retriever puppy.
Read Dr. Kleiman’s Full Bio
Link to Dr. Kleiman’s Publications
Jessica S. Sheeran, MD
Jessica S. Sheeran, MD
Dr. Jessica Sheeran is an Associate Professor of Anesthesiology, specializing in obstetrics and medical simulation. Dr. Sheeran graduated from the University of Virginia SOM, and she completed her anesthesiology residency at UVA. To further advance her training, Dr. Sheeran undertook 9 months of specialized study in obstetric anesthesiology, and finished with an Obstetric Anesthesia Fellowship at UVA.
Dr. Sheeran is a Board certified anesthesiologist. At UVA, Dr. Sheeran serves on the Perinatal Clinical Practice Committee. Nationally, Dr. Sheeran is a member of the Society of Obstetric Anesthesia & Perinatology, Simulation & Patient Safety Subcommittee. Dr. Sheeran lectures broadly across UVA on obstetric anesthesia practices and has mentored many resident projects in her area of expertise.
In 2017, she was appointed as Assistant Director of the School of Medicine 3rd year Perioperative Clerkship. In 2021, she was appointed Director of Simulation for the UVA SOM SAGO Clerkship (Surgery, Anesthesia, Ob/Gyn Clerkship).
Mohamed Tiouririne, MD
Mohamed Tiouririne, MD
Dr. Tiouririne is a professor in the Department of Anesthesiology at the University of Virginia. He is a trained Obstetrician and Gynecologist, Anesthesiologist and a Critical Care Medicine Doctor. Dr. Tiouririne is considered an expert in Obstetric Anesthesiology and holds a dual appointment with the department of Obstetrics and Gynecology. His interests expand beyond the labor and delivery unit and encompass critical care medicine with a specific interest in maternal critical care.
He is the medical Director of our Surgical Admission Suite and Post Anesthesia Care Unit (PACU). Dr Tiouririne served as the Director of Obstetric Anesthesiology for many years and served as the Co-chair for the establishment of the Society of Obstetric Anesthesia and Perinatology recommendation for ERAS after Cesarean section. He was the recipient of the Dean’s Clinical Excellence Award in 2017.
Read Dr. Tiouririne’s Full Bio
Link to Dr. Tiouririne’s Publications
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.