June 10, 2019

Texas Children’s Pavilion for Women has been designated a level IV maternal care facility, the highest level of care available. The designation was finalized late last week and followed a rigorous site visit conducted by the EMS/Trauma Systems Office of the Texas Department of State Health Services. A level IV maternal care facility provides comprehensive care for pregnant and postpartum patients, from those with low-risk conditions up to and including the most complex medical, surgical and/or obstetrical conditions that present a high-risk of maternal morbidity or mortality.

“This designation certifies that we offer the highest level of care for the most complex obstetric patients,” said Dr. Christina Davidson, a maternal-fetal medicine specialist and chief quality officer at Texas Children’s Pavilion for Women. “It speaks to the expertise of our clinical teams and the processes we have in place to ensure high-quality care and the positive outcomes we strive for.”

With the overall goal of reducing infant and maternal morbidity and mortality in the United States, the designation comes as the result of legislation passed in 2013 requiring Texas to establish and implement neonatal and maternal level of care designations by March 1, 2018. The intent of the legislation is to ensure both neonatal intensive care units (NICUs) and maternal care facilities have the resources and expertise to provide high-quality, specialized patient care that leads to the best outcomes for mothers and babies.

Texas is one of the first states requiring maternal care facilities undergo a site visit to verify the level of care provided to patients meets the Maternal Levels of Care classifications as defined in the Texas Administrative Code. Completing the designation process is a requirement to receive Medicaid reimbursement for obstetrical care by August 31, 2020.

“This designation is the fruit of the work we perform daily. It is recognition by the Department of State Health Services of Texas Children’s commitment and investment to maternal health,” said Dr. Nan Ybarra, director of nursing for inpatient services at Texas Children’s Pavilion for Women. “With over 6,200 deliveries annually, we are committed to serving women in our community and partnering with community hospitals to strengthen their maternal care processes and programs – our singular goal is to improve outcomes for pregnant women across Texas and beyond.”

Texas Children’s announced in January it opened one of the nation’s few intensive care units dedicated solely to obstetrical critical care. It is the only four-bed maternal ICU in the country staffed 24/7 by both pulmonary critical care and maternal-fetal care teams embedded in a hospital’s labor and delivery unit. This maternal ICU offers a specialized, private space for high-risk expectant and postpartum mothers with conditions such as sepsis, peripartum bleeding, placenta accreta, maternal heart disease and other serious conditions.

The hospital also has a nationally known placenta accreta spectrum program, where a team of experts provide comprehensive, multidisciplinary care for women with this potentially life-threatening pregnancy complication that occurs in approximately 1 in 1,000 to 2,000 pregnancies.

Additionally, in 2017, Texas Children’s obstetrics service partnered with the hospital’s Kangaroo Crew to create the Maternal Transport Service, further bolstering its reputation as a primary referral site for patients with high-risk pregnancies. The team, consisting of a Kangaroo Crew nurse, labor and delivery nurse, respiratory therapist, and EMT, can provide specialty care to mothers while enroute to the Pavilion for Women, helping the hospital’s community partners transport their sickest patients for the most optimal outcomes for mothers and babies.

“It’s crucial for women, especially those experiencing a high-risk pregnancy, to be educated about the level of obstetrical care available in the facility in which they plan to deliver,” said Dr. Michael Belfort, obstetrician/gynecologist-in-chief at Texas Children’s Pavilion for Women.

The Texas Children’s Pavilion for Women garnered several top distinctions in medical care for women and babies by excelling in maternity quality measures like breastfeeding practices, minimally invasive gynecology and exceeding patient satisfaction. Learn more by visiting our 2018 virtual Annual Report.

June 3, 2019

Whenever anyone asks about Shamika Jenkins, the first observation made is about her infectious smile and enthusiastic personality.

Customer service isn’t just a specific portion of an employee’s job description, it affects a patient’s entire experience. As a clerical secretary, Jenkins comes in contact with just about every patient that checks in during her early morning shift. In the Pavilion for Women Surgery department the patient’s experience begins with her warm welcomes and persistence.

“Although it can be pretty busy, I love meeting all different kind of people,” Jenkins said. “There are times when some people may be in a bad mood, a wonderful mood, some may be lost, and others are as upbeat and cheery as I am. Regardless, it gives me joy to encounter all moods because no matter what, I’m here to make their day.”

The waiting area can be the most quiet and uneventful time during a patient’s hospital visit. Either following check in, during an appointment, or after surgery as a patient recovers, patients and their families can potentially spend hours sitting in the lobby. Jenkins has transformed her role into not just checking patients in for their appointments, but makes them feel comfortable as well.

“Shamika is always the pretty, smiling face and helpful person in the waiting room,” Nursing Manager of Pavilion for Women Perioperative Services, Aleli Cabali said. “Shamika goes above and beyond to make sure that families in the waiting room are updated while patients are in the operating room.”

Jenkins’ diligence and consistence in making sure all surgery patients are called and scheduled for their appointments helps both patients and her co-workers, and is what allows the department to continuously provide high quality care.

“I remember a time when several people from the department had to go on vacation, and Shamika called patients ahead of time and scheduled their appointment to make it easier on the rest of the team,” Cabali said. “This was a big help to the unit and is why she deserves this award.”

Jenkins says despite the constant verbal recognition that she receives, she was not expecting to get a hospital-wide award.

“To be honest I didn’t see this coming,” she said. “I just come into work, do my job, and always remember to be myself; that is probably what excites me the most about being recognized. When working at Texas Children’s you have to be ready to put your ‘A game’ on every day. We have people come from everywhere so we need to make sure we maintain that great customer service consistently, and I am more than happy to be that example.”

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.