February 4, 2019

When Blessing Quartey was born, she was only 24 weeks old and weighed just 1.8 pounds.

To help boost her growth, Blessing’s mother, Eva Nehikare, agreed to enter her daughter into an ongoing study at Texas Children’s Pavilion for Women focused on the benefits of an exclusive human milk-based diet in extremely low-birth-weight babies. Five months later, Eva is thankful she did.

“Shortly after she got into the study, you could see her becoming more muscular and full,” Eva said. “When you look at her now, you would never know she is a preemie.”

Today, Blessing weighs 8 pounds. She is steadily gaining weight and growing, and was discharged from the hospital just before the holidays.

Dr. Amy Hair, neonatologist and director of the neonatal nutrition program at Texas Children’s Hospital, is leading the study Blessing is in and said the infant’s outcome isn’t uncommon.

“We’ve known for a while that a human milk-based diet is best for low-birth-weight babies,” Hair said, noting that Texas Children’s was the first pediatric hospital to adopt an exclusive human milk-based diet in the neonatal intensive care unit (NICU) in 2009. “Now, we have a study and outcomes to back us up.”

Hair recently published some of the study’s outcomes in the BMJ, one of the world’s oldest and most highly revered peer-reviewed medical journals.

Specifically, the study looked at the benefits of an exclusive human milk-based diet in 51 premature infants. It compared post-discharge growth, obesity and metabolic outcomes of appropriate for gestational age (AGA) premature infants versus small for gestational age (SGA) premature infants who were fed an exclusive human milk-based diet in the NICU.

The first to look at long-term post-discharge growth of this population, the study found that at 2-years-old SGA premature infants who received an exclusive human milk-based diet showed greater catch-up growth without increased obesity or elevated insulin resistance compared with AGA premature infants. These findings suggest an exclusive human milk-based diet in the NICU could lead to favorable metabolic outcomes in SGA children.

“Historically, we have overfed premature babies with either formula or cow-based fortifier, which has led to a higher risk of heart disease and metabolic problems as young adults,” Hair said. “This study proves that feeding with human milk and human milk fortifier, low-birth-weight babies grow in a healthier manner. The study also challenges the current belief that SGA babies will never catch up to their counterparts. We are seeing that they are.”

Hair said the next paper to come out about the study will focus on participants’ neurodevelopment. She added that she and her partners have seen positive results and that the families involved are extremely pleased and more than willing to participate and come in for follow-up visits.

“I am so thankful for all of the care my daughter and I received at the Pavilion for Women,” Eva said. “The opportunity for us to be a part of this was an honor.”

January 28, 2019

Drs. Jimmy Espinoza and Alex Vidaeff were recently honored by the American College of Obstetricians and Gynecologist (ACOG) for preparing new guidelines for the management and prevention of complications of pregnancy including preeclampsia and gestational hypertension as well as chronic hypertension during pregnancy.

These pregnancy complications are among the leading causes of maternal death in the United States and abroad. The new guidelines on how to manage and prevent these complications were published in Obstetrics and Gynecology the official journal of the ACOG.

“Your contributions to the medical literature on hypertensive disorders in pregnancy were paramount in helping the Practice Bulletin Committee – Obstetrics develop and implement these two critical documents,” said Dr. Mark Turrentine, chair of the ACOG Bulletin Committee – Obstetrics. “While ACOG does not state its guidelines should be considered the standard of care, I suspect these documents will be utilized to guide clinician’s management of hypertensive disorders of pregnancy not only in the United States, but worldwide.”

Turrentine also said the appropriate treatment of hypertensive diseases in pregnancy may be the most important focus of our attempts to improve maternal mortality and morbidity in the United States, and that the new guidelines will focus clinicians on providing the right and the best care based on the latest and soundest available evidence.

Espinoza’s clinical interests include the pregnancy complications listed above; in addition, his clinical and research interest include prenatal diagnosis of congenital defects with emphasis of congenital heart defects as well as fetal interventions including laser photocoagulation of placental anastomoses in twin-to-twin transfusion syndrome, fetoscopic tracheal occlusion in cases of severe congenital diaphragmatic hernia and open/fetoscopic repair of spina bifida among other interventions. He is board certified in Obstetrics and Gynecology and serves as co-director of the Fetal Center and in the Division of Fetal Intervention and Therapy at Baylor College of Medicine. Espinoza earned his medical degree at San Fernando Faculty of Medicine, University of San Marcos in Lima, Peru. He completed his residency in Obstetrics and Gynecology at William Beaumont Hospital, Royal Oak, MI. Espinoza earned his Master in Science in Reproductive Health at the University of Cardiff, Wales, where he graduate with distinction, followed by a Diploma in Fetal Medicine under the auspices of the Fetal Medicine Foundation in London, UK.

Vidaeff has extensive experience in the management of multiple pregnancies, preterm labor, and preeclampsia. He specializes in the management of medical complications in pregnancy. Vidaeff is board certified in Obstetrics and Gynecology and in Maternal-Fetal Medicine. He completed his residency at Temple University in Philadelphia. He completed his fellowship training in Maternal-Fetal Medicine at The University of Texas Medical School at Houston. Vidaeff also holds a Masters in Public Health from The University of Texas School of Public Health at Houston. He is the chairman of the steering committee of the World Organization Gestosis, international organization for the study of pathophysiology of pregnancy.

January 14, 2019

On January 10, leaders with Texas Children’s Pavilion for Women cut the ribbon on the facility’s new four-bed OB-GYN intensive care unit.

Located in the Labor and Delivery Unit on the ninth floor, the ICU offers a specialized, private space for high-risk expectant and postpartum mothers with conditions such as:

  • Sepsis
  • Peripartum bleeding
  • Hypertensive disorders
  • Placenta accreta
  • Maternal heart disease
  • Diabetes and other endocrine disorders
  • Cancer
  • Organ transplant

“This beautiful space gives our highly trained clinicians the perfect place to carry out specialized services we’ve offered to our high-risk patients since opening in 2012,” said Lynda Tyer-Viola, vice president of nursing. “Having comprehensive family centered perinatal services in such a setting will help us continue to make a dramatic difference in the lives of expectant mothers with critical complications of pregnancy.”

The Pavilion for Women is home to one of the nation’s few ICUs dedicated solely to obstetric critical care, and the only four-bed maternal ICU in the nation staffed 24/7 by a pulmonary critical care and maternal fetal care team embedded in a hospital’s labor and delivery unit.

The unit’s new space will offer critically ill obstetric patients the latest life-saving equipment and fetal monitoring systems and a dedicated ICU team including 24/7 critical care physicians, maternal-fetal medicine specialists, and an ICU-trained and ACLS (advanced cardiovascular life support)-certified nursing staff.

The ICU team collaborates closely with Baylor College of Medicine subspecialties including cardiology, hematology and nephrology, among others. The unit and team is also one of the most experienced in the nation in the care of post fetal surgery mothers. Uniquely, expectant mothers with a history of cancer or a new gynecologic cancer diagnosis, will also benefit from the expert care and the most advanced treatment therapies available through our renowned colleagues in gynecologic oncology.

“While life threatening illness or medical conditions add to the complexity of any pregnancy, we are fortunate to have a multidisciplinary clinical team and resources that address the needs of both mother and fetus during this very crucial period,” said Dr. David Muigai, medical director of the maternal ICU. “We feel a deep sense of privilege and pride to be able to further contribute to the overall Texas Children’s mission by offering the highest quality and most comprehensive medical services available to expectant mothers and their babies.”

Dr. Manisha Gandhi, chief of maternal-fetal medicine, agreed and said at the ribbon cutting that she was extremely excited about the continued collaboration between disciplines that the new ICU will enable and encourage.

“The need for higher level, specialized care for women has grown exponentially,” Gandhi said. “Having a dedicated space for maternal ICU services will put us in a good place to better serve these patients during this critical time.”

OB-GYN-in-chief Dr. Michael Belfort said the new ICU is an extremely important tool that will help the specially trained clinicians in the unit take care of the sickest of the sick.

“Unfortunately, maternal mortality is increasing in the United States and Texas,” Belfort said. “With this unit, we are better able to care for those who need us the most.”

For more information about the Pavilion’s maternal ICU, the development of which was led by Liz Bolds, assistant clinical director of high-risk nursing, click here.

December 11, 2018

Dr. Carla Ortique, an OB/GYN with Texas Children’s Pavilion for Women, was recently named physician of the year by the Houston Medical Forum, a component society of the National Medical Association.

The forum was established in 1926 to address the needs of physicians of African descent and their patients. Today, the Houston Medical Forum is the National Medical Association’s largest local affiliate. Its members represent a myriad of specialties and engage in a variety of activities that advance the art and practice of medicine as well as promote education and wellness in the community, eliminate health disparities and sustain physician viability.

“I feel incredibly blessed and honored to be recognized by this organization,” Ortique said.

Ortique earned a B.S. in bacteriology from the University of Wisconsin-Madison in 1982 and her medical degree from the University of Illinois College of Medicine in 1986. Ortique completed an internship and residency in family medicine at the University of Illinois.

A strong interest in providing comprehensive care for women, coupled with the personal experience of having a sister diagnosed with breast cancer, resulted in Ortique undertaking a second residency program. She completed her training in obstetrics and gynecology at St. Paul Ramsey Medical Center in St. Paul, Minn., in 1995.

Ortique has been in the active practice of obstetrics and gynecology in Texas since August 1995. Board-certified in obstetrics and gynecology since 1997, she incorporates her family medicine training as well as training in complementary and alternative therapies to provide comprehensive care to female patients. Her areas of special interest include spirituality and medicine, general obstetrics, minimally invasive surgical procedures including hysteroscopy and laparoscopy, preventative health care and patient safety, guidance for perimenopausal and menopausal patients. Ortique also is interested in health equity and elimination of racial and ethnic health care disparities and elimination of preventable maternal deaths.

November 19, 2018

The neonatal intensive care unit (NICU) at Texas Children’s Pavilion for Women celebrated babies this past week in recognition of Prematurity Awareness Month. Infants on the unit received superhero capes, created by FirstMemories Texas, an all-volunteer organization dedicated to teaching families whose infants are in the NICU and CVICU at Texas Children’s Hospital how to celebrate, honor and tell their children’s stories through photography and album making.

One family got three capes – one for each of their triplet sons, Barrett, Calvin and Jacob. The brothers were born on November 1 at 34 weeks gestation and have been in the NICU ever since. All three babies are healthy but need some extra attention and care before going home.

Dara Miller, the boys’ mother, said the care she and her boys have received at the Pavilion for Women has been incredible and that everyone they have encountered has been professional, compassionate and kind.

“We have had complete confidence in everyone who has taken care of us,” Miller said. “Everyone has always kept us informed and made us feel like we are in the best possible hands.”

The day her boys received their black and yellow batman capes was icing on the cake and ended up sparking a milestone moment. Until that day, she had never held her boys together, only separately. Joined by her husband, Mason, and 2-year-old daughter, June, Miller held her babies donned in capes big enough to cover almost their entire body and grinned widely.

“In that moment, we all came together as a family,” she said. “Until then, something felt incomplete.”

Kellie Kainer, assistant clinical director of nursing for the NICU, said comments like Miller’s and special events like the one with the capes bring smiles to her and her staff as well. Knowing that patients and their families are comfortable with the care they receive is huge.

“Everyone in the NICU has a passion for what they do,” she said. “We truly love caring for some of Texas Children’s most fragile patients.”

Texas Children’s Hospital, together with Texas Children’s Pavilion for Women, house the nation’s largest level IV NICU, the highest level of care available for premature and critically-ill newborns. Babies born prematurely require round-the-clock care and often need access to highly specialized services to have the most optimal outcomes. Complications from premature birth (before 37 weeks gestation) are the #1 cause of death of babies in the United States and 1 in 10 babies in the U.S. are born too soon.

November 13, 2018

On November 8, Texas Children’s friends and supporters attended The Forum Luncheon highlighting the amazing work of Texas Children’s Pavilion for Women. Held at The Post Oak Hotel at Uptown Houston, the program shined a bright light on the many successes the Pavilion for Women has had since opening its doors in 2012.

In just six short years, more than 37,000 babies have been delivered at the hospital, including 1,200 sets of multiples, one of which was a set of sextuplets. Almost 8,000 babies have been treated in the hospital’s Neonatal Intensive Care Unit, and many lives have been saved or greatly altered by the talented clinical staff that works tirelessly to improve the lives of women and children.

“I can’t imagine Texas Children’s without the Pavilion for Women and am thrilled we had the vision, aspiration and courage to build it,” said President and CEO Mark Wallace during his opening remarks at the forum. “In just five years, we translated our vision for this new paradigm of care into a reality that has helped countless mothers and their children.”

Hired to lead Texas Children’s Pavilion for Women shortly after it opened, Dr. Michael Belfort, fetal surgeon and Ob-Gyn-in-chief, headlined the forum’s program taking the almost 400 people in the audience on a journey through the organization’s wide variety of services offered to women and children.

Some of those services areas include:

  • Pediatric and adolescent gynecology
  • Fertility
  • High-risk pregnancy
  • Fetal surgery and prenatal care
  • Global women’s health
  • Menopause and urogynecology
  • Mental health

“I was drawn to Texas Children’s from the very beginning because of the vision they had for women and children,” Belfort said. “We have come a long way in a short time, and while I’m proud of our accomplishments, I don’t think we should ever stop trying to be even better.”

The forum’s program ended with an emotional story told by Emma Tramuto, who at 17 weeks pregnant was told her baby, Ella Rose, was diagnosed with gastroschisis, which is failure of the abdomen to close completely, resulting in the baby having her intestines outside of her body.

Emma and her husband James visited many physicians and surgeons, and were told multiple times their only choice was to terminate the pregnancy – that is until they came to Texas Children’s Pavilion for Women where a team of clinicians cared for Emma and Ella Rose, who is now a vibrant 6-year-old little girl.

“Miracles happen every day at Texas Children’s Hospital and perhaps the biggest miracles are the ones for the tiniest patients,” Emma said. “Our daughter is one of these incredible miracles. Had it not been for Texas Children’s Hospital Ella Rose would not be here today. The doctors and nurses who cared for Ella gave her a chance at life she would not have had one otherwise.”

August 27, 2018

Texas Children’s Pavilion for Women and two of its surgeons recently received superior patient care designations from the Surgical Review Corporation, which develops and administers best-in-class accreditation programs for surgeons, hospitals and freestanding outpatient facilities throughout the world.

After a rigorous review process, the SRC accredited the Pavilion for Women as a Center of Excellence for Minimally Invasive Gynecology and two of its surgeons – Dr. David Zepeda and Dr. Xiaoming Guan – as Surgeons of Excellence in Minimally Invasive Gynecology.

The Pavilion for Women is now one of three hospitals in Houston and one of five in Texas with the Center of Excellence designation.

“Earning this accreditation signifies our ability to consistently deliver the safest, high-quality care to our patients,” said Nakeisha Archer, director of perioperative services for the Pavilion for Women. “Our program fosters quality improvement in surgery, and commitment to this process has focused our team on exceeding clinical benchmarks and guidelines. Most importantly, our commitment to excellence will improve the health and well-being of our patients. We are so proud to be leaders in quality care for women.”

Minimally invasive gynecologic surgery includes hysteroscopic, laparoscopic and/or vaginal procedures such as hysterectomies, fibroid removals and myomectomy excisions. Surgeons at the Pavilion for Women did almost 500 minimally invasive surgeries in 2017 and are on track to do more this year.

Karen Rosser recently had a minimally invasive procedure done with Zepeda and said her experience with the surgeon and the Pavilion for Women was incredible.

“I felt comfortable every step of the way,” said Rosser, who suffered chronic pain for years due to adenomyosis. “I never flinched at moving forward with surgery and am confident I received the best care.”

Zepeda said he is proud of the designations and believes they distinguish the Pavilion for Women as a leader in minimally invasive surgery.

“SRC’s accreditation program recognizes surgeons and facilities that demonstrate an unparalleled commitment and ability to consistently deliver safe, effective, evidence-based care,” he said. “This has always been our focus at the Pavilion for Women and always will be.”

Guan agreed and said he hopes patients looking for quality care can now be even more assured that the Pavilion for Women is the place to be knowing we have met rigorous standards for delivering high-quality perioperative and long-term follow-up care.

More about the surgeons

Dr. David Zepeda was born and raised in Houston and attended The University of Texas at Austin. Zepeda received his medical degree at the University of Texas at San Antonio Health Science Center in 1974. He completed obstetrics and gynecology residency at Baylor College of Medicine in Houston in 1978. Zepeda maintains an academic appointment as clinical associate professor at Baylor College of Medicine, where he is involved in residency and medical student education. He’s recognized in the Texas Medical Center for his expertise in gynecologic surgery, including pelvic reconstruction, DaVinci Robotic Surgery and advanced laparoscopic and hysteroscopic procedures. He is board-certified by the American College of Obstetrics and Gynecology and has voluntarily recertified numerous times. He has been awarded the Distinguished Surgeon of the Year in Houston and has been voted among the Best Doctors of America. In addition to teaching, Zepeda has been involved with National Scientific Meetings in Ob/Gyn and has published on laparoscopic surgery. He is actively involved in continuing medical education through the medical center and national meetings in the specialty as well as numerous professional societies.

Dr. Xiaoming Guan
Dr. Xiaoming Guan is the Section Chief and Fellowship Director of Minimally Invasive Gynecologic Surgery at Texas Children’s and is an associate professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine. Dr. Guan earned his medical degree at Fujian Medical College, Fuzhou in Fujian, China. He completed his Obstetrics and Gynecology residency at St. Joseph’s Hospital, a Mount Sinai School of Medicine affiliated hospital, in Paterson, NJ, followed by a fellowship in Minimally Invasive Gynecologic Surgery at Baylor College of Medicine in Houston. Dr. Guan brings extensive experience in treating complex and challenging cases of endometriosis, uterine fibroids, and pelvic masses. He is a leader in minimally invasive gynecologic surgery and a pioneer in the use of state-of-the-art robotic single-site technology and traditional single site and transvaginal Natural Orifice Endoscopy Surgery (NOTES) for advanced pelvic surgery. He also applies single-site or NOTES surgical technique in treatments of cervical incompetence with abdominal cerclage, urinary incontinence with sling, and pelvic organ prolapse with sacrocolpopexy. He serves on the editorial boards of the Journal of Minimally Invasive Gynecology and he is the author of numerous more than 40 publications.

More about SRC
Established in 2003, SRC is an internationally recognized patient safety organization dedicated to recognizing and refining surgical care. SRC is the leading administrator of quality improvement and accreditation programs for surgeons and hospitals worldwide. SRC’s proven methodology, known as the “Cycle of Excellence,” results in quantifiable and unparalleled improvement in the outcomes, patient safety and costs across surgical specialties. To measure improvement and develop best practices, SRC offers a multispecialty outcomes database that is the world’s largest repository of clinical patient data for minimally invasive gynecologic and bariatric surgery.