FETAL & MATERNAL IMAGING

ABOUT THE PROGRAM

Imaging is a powerful instrument for scientific discovery that has changed the practice of medicine – particularly in obstetrics. A major step forward in recent decades has been to transform the fetus from an “invisible” to a visible subject through the use of novel imaging methods. Challenges include using such techniques to gain insight into the anatomy, physiology, and biochemistry of pregnancy. The Fetal and Maternal Imaging Division is an essential part of the PRB, as it studies fetal anatomy, growth, and physiologic parameters, as well as maternal anatomy by using conventional and novel imaging methods [e.g. three- and four-dimensional (3D/4D) sonography, Doppler velocimetry, cervical elastography]. The Division has been specifically recognized for its experience and leading expertise in 3D/4D ultrasound to improve the detection of congenital anomalies, as well as fetal growth. There is a large clinical component, in which the Division is responsible for performing sonographic examinations on pregnant women receiving care at Detroit Medical Center, and on those who are referred for evaluation by other practices/institutions in the surrounding area.

OBJECTIVES

To improve the assessment of normal and abnormal anatomy / function of the human fetus using innovative imaging modalities (e.g. three- and four-dimensional ultrasound)
To assess fetal growth, weight, and development (including soft tissue parameters) with the use of ultrasound and develop new methods for growth assessment
To study maternal anatomy (e.g. uterine cervix, pelvic floor, Doppler velocimetry) using conventional and novel imaging techniques in normal and high-risk pregnancies and use such information to identify those at risk for adverse pregnancy outcomes
To participate in imaging components of other protocols and cross-sectional / longitudinal studies conducted by the PRB (e.g. preterm labor, preeclampsia)
To provide a strong clinical component – the Program performs imaging on pregnant women at our institution, as well as on those referred from other practices and institutions in the surrounding area
To train Maternal-Fetal Medicine Fellows and other health care providers in fetal and maternal imaging

RESEARCH HIGHLIGHTS

Created a customized approach to cervical length assessment that considers relevant maternal characteristics and gestational age at sonographic examination
Developed the new Detroit fetal growth standard for African-American women, customized for maternal height, weight, parity, and fetal gender
Demonstrated that elastography of the uterine cervix can be used for risk assessment of preterm birth in the mid-trimester
Prospective validation of new fetal weight prediction models that have combined two- and three-dimensional sonographic parameters
Applied the novel fractional limb volume tool (soft tissue parameter for fetal growth) for IGA
Developed a novel sonographic approach to evaluate fetal growth, known as Individualized Growth Assessment (IGA), as well as a freely available internet-based software application to allow personalized analyses of fetal growth based on IGA principles (Individualized Growth Assessment Program, or iGAP)
Determined that amniotic fluid “sludge” is a sonographic biomarker for intra-amniotic infection and inflammation, as well as an independent risk factor for preterm prelabor rupture of membranes, and spontaneous preterm delivery
Developed a novel approach to assess the risk for preeclampsia and small for gestational age fetuses in the second trimester which incorporates Doppler velocimetry of the uterine arteries
Demonstrated the diagnostic capabilities and value of three-dimensional sonography during pregnancy

SELECT PUBLICATIONS, JOURNAL COVERS, EDUCATIONAL MATERIAL

Reduced fetal growth velocity precedes antepartum fetal death. Pacora P, Romero R, Jung E, Gudicha DW, Hernande-Andrade E, Musilova I, Kacerovsky M, Jaiman S, Erez O, Hsu CD, Tarca AL. Ultrasound Obstet Gynecol 2020; online ahead of print.
Optical ultrasound simulation-based training in obstetric sonography. Yeo L, Romero R. J Matern Fetal Neonatal Med 2020:1-16.
Prediction of adverse perinatal outcome by fetal biometry: comparison of customized and population-based standards. Kabiri D, Romero R, Gudicha DW, Hernande-Andrade E, Pacora P, Benshalom-Tirosh N, Tirosh D, Yeo L, Erez O, Hassan SS, Tarca AL. Ultrasound Obstet Gynecol 2020;55:177-188.
Individualized growth assessment: conceptual framework and practical implementation for the evaluation of fetal growth and neonatal outcome. Deter RL, Lee W, Yeo L, Erez O, Ramamurthy U, Naik M, Romero R. Am J Obstet Gynecol 2018;218:S656-S678
Cervical strain determined by ultrasound elastography and its association with spontaneous preterm delivery. Hernande-Andrade E, Romero R, Korzeniewski SJ, Ahn H, Aurioles-Garibay A, Garcia M, Schwartz AG, Yeo L, Chaiworapongsa T, Hassan SS. J Perinat Med 2014;42:159-169.

FACULTY

LAMI YEO, M.D., F.A.C.O.G., F.A.I.U.M.

Director of Fetal Cardiology, Perinatology Research Branch, NICHD/NIH Director, DMC / WSU / PRB, Maternal-Fetal Medicine Fellowship Program

FULL BIO

Bioinformatics & Computational Biology

Biomarkers for the ‘Great Obstetrical Syndromes’

Center for Advanced Obstetrical Care & Research (CAOCR)

Fetal Cardiology

Fetal & Maternal Imaging

About the Program
Objectives
Research Highlights
Select Publications, Journal Covers, Educational Material
Perinatal Neural Connectivity
Faculty
Functional and Molecular Ultrasound and Optical Maternal and Fetal Imaging

Inpatient Research

Maternal-Fetal Immunobiology

Maternal-Fetal Microbiome

Maternal-Fetal Mitochondrial Metabolism

Maternal-Fetal Single Cell Genomics

Molecular Evolution of Reproduction

MRI for Fetal Imaging

Perinatal Epidemiology, Systematic Reviews and Meta-analyses

Placental Pathology