About the Program
"Pregnancy is where preventive medicine will begin in the 21st century."
The Center for Advanced Obstetrical Care and Research (CAOCR) is an innovative research center designed to provide pregnant women with the opportunity to participate in perinatal research while receiving high quality prenatal care from physicians at Hutzel Women’s Hospital. The collaboration between research and clinical care encourages patient participation in the protocols of the Perinatology Research Branch and offers mothers convenient access to prenatal care through the coordination of research activities and clinical care services. Ultimately, both mothers and researchers benefit from this integrated approach. Research protocols conducted at the CAOCR enable investigators to study normal maternal-fetal anatomy and physiologic processes as well as the mechanisms of disease associated with perinatal disorders and adverse pregnancy outcomes. These scientific advances in the understanding of maternal-fetal medicine have led to the development of diagnostic, therapeutic, and preventive strategies used to improve the quality of maternal and fetal health. In addition, the CAOCR serves the community in its provision of early access to prenatal care and support of maternal health education for underserved mothers throughout the Detroit area.
- A multi-disciplinary team of providers collaborates to provide a comprehensive model of prenatal care based on state-of-the-art perinatal research and technology including advanced surveillance of the cervix for preterm birth risk assessment through the use of routine transvaginal ultrasound.
- Research protocols include women with both normal and complicated pregnancies with a specialization in the evaluation of high-risk pregnancy conditions such as:
- Preterm birth
- Early pregnancy loss
- Vaginal bleeding
- A small or large for gestational age fetus
- Twin pregnancies
- Maternal-Fetal Medicine Fellows have the opportunity to participate in the implementation and analysis of the longitudinal research protocols conducted at the CAOCR. In addition, they gain valuable knowledge about how scientific investigations involving the documentation of research data, collection of biologic specimens, performance of advanced fetal imaging, and the initiation of high-risk therapeutic strategies allow researchers to study the mechanisms of disease associated with maternal-fetal disorders.
- Advanced training in ultrasound and imaging techniques is also available to Maternal-Fetal Medicine Fellows at the CAOCR.
If you are a woman that is pregnant or planning on becoming pregnant and would like to participate in research, please contact:
The Center for Advanced Obstetrical Care & Research
Hutzel Women's Hospital
4 Webber North (4th Floor)
3990 John R
Detroit, MI 48201
Or call (313) 577-8832 to see if you are eligible to participate and make an appointment with us.
Click the following video links to hear from our patients about their experiences.
- The CAOCR supports the scientific goals of the Perinatology Research Branch through the operationalization of research protocols and special projects including:
- Collection of data and biological samples for the study of biomarkers to predict preterm birth and other adverse pregnancy outcomes
- Longitudinal sonographic evaluation of risk factors for obstetric complications such as preterm birth and the identification of shortened cervical length and amniotic fluid sludge
- Execution of interventional therapeutic strategies for the prevention of maternal-fetal complications
- In addition, the CAOCR research staff supports study participants through the provision of ongoing prenatal education, promotion of postpartum risk reduction strategies, and recognition of their contributions to the improved health of future mothers and babies.
- The study of the cervix and it role in the prediction of preterm birth
- A description of the uterine cervix transcriptome
- A randomized clinical trial of "The Effect of Vaginal Progesterone Administration in the Prevention of Preterm Birth in Women with a Short Cervix"
- The longitudinal study of angiogenic and anti-angiogenic factors in the prediction of pre-eclampsia
- Comprehensive exploration of maternal and fetal factors that predict the subsequent development of adverse pregnancy outcomes
Important Points & Discoveries
- A sonographic short cervix as the only clinical manifestation of intraamniotic infection
- The risk of preterm delivery in asymptomatic patients with a short cervix
- Identification of amniotic fluid sludge as a powerful predictor of preterm birth
- Identification of biomarkers for the prediction of pre-eclampsia and small for gestational age [fetuses/neonates]
- The study of angiogenic factors and their relationship to maternal and fetal Doppler abnormalities
- Characterization of the Uterine Cervix transcriptome after term labor and delivery
- Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2011 Jul;38(1):18-31. doi: 10.1002/uog.9017. Epub 2011 Jun 15. Hassan SS, Romero R, Vidyadhari D, Fusey S, Baxter J, Khandelwal M, Vijayaraghavan J, Trivedi Y, Soma-Pillay P, Sambarey P, Dayal A, Potapov V, O'Brien J, Astakhov V, Yuzko O, Kinzler W, Dattel B, Sehdev H, Mazheika L, Manchulenko D, Gervasi MT, Sullivan L, Conde-Agudelo A, Phillips JA, Creasy GW; for the PREGNANT Trial
- Sonographic short cervix as the only clinical manifestation of intra-amniotic infection. Journal of Perinatal Medicine 2006;34:13-19. Hassan SS, Romero R, Hendler I, Gomez R, Khalek N, Espinoza J, Nien JK, Berry SM, Bujold E, Camacho N, Sorokin Y
- Signature pathways identified from gene expression profiles in the human uterine cervix before and after spontaneous term parturition. American Journal of Obstetrics and Gynecology 2007;197:250.e1-7. Hassan S, Romero R, Tarca AL, Draghici S, Pineles B, Bugrim A, Khalek N, Camacho N, Mittal P, Yoon BH, Espinoza J, Sorokin Y, Malone J, Jr
- Clinical significance of the presence of amniotic fluid "sludge" in asymptomatic high-risk patients for spontaneous preterm delivery. Ultrasound in Obstetrics and Gynecology 2007;30: 706-714. Kusanovic JP, Espinoza J, Romero R, Gonçalves L, Nien JK, Soto E, Khalek N, Camacho N, Hendler I, Mittal P, Friel LA, Gotsch F, Erez O, Than NG, Mazaki-Tovi S, Schoen ML, Hassan SS
- The maternal plasma soluble vascular endothelial growth factor receptor-1 concentration is elevated in SGA and the magnitude of the increase relates to Doppler abnormalities in the maternal and fetal circulation. Journal of Maternal Fetal and Neonatal Medicine 2008;21:25-40. Chaiworapongsa T, Espinoza J, Gotsch F, Kim YM, Kim GJ, Goncalves LF, Edwin S, Kusanovic JP, Erez O, Than NG, Hassan SS, Romero R
- The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age. Journal of Maternal Fetal and Neonatal Medicine 2008;21:279-287. Erez O, Romero R, Espinoza J, Wenjiang F, Todem D, Kusanovic JP, Gotsch F, Edwin S, Nien JK, Chaiworapongsa T, Mittal P, Mazaki-Tovi S, Than NG, Gomez R, Hassan SS