About the Program
The state-of-the art facilities of the Hutzel Women’s Hospital Labor and Delivery Unit include:
- Approximately 4,000 deliveries per year
- High-risk population
- Seventeen birthing rooms and 4 obstetrical operating rooms
- Maternal Special Care Unit (MSCU)
- Five-bed unit offering telemetry and high risk monitoring
- The only maternal ICU in Michigan
- Fetal therapy procedure rooms for clinical training in cordocentesis, intrauterine fetal transfusions, fetal endoscopy and radiofrequency ablation
- Fellow participation in the care of fetuses with lethal, non-lethal malformations and genetic syndromes
- Opportunities for clinical research and education:
- Design and participate in clinical research
- Collaboration with Neonatology, Cardiology, and Critical Care Pediatrics
- Daily Research Rounds: presentation and discussion of current cases, patient management, and review of pertinent scientific literature
- To study the mechanisms of disease of the Great Obstetrical Syndromes: preterm labor, preeclampsia, preterm prelabor rupture of membranes, fetal growth restriction, and fetal demise
- Study of the progress of normal and abnormal labor
- Implementation of perinatal clinical research protocols
- Clinical training of MFM fellows
- Characterization of the interaction between inflammation and angiogenesis in normal and complicated pregnancies
- Identification of women with preterm labor and intra-amniotic infection/inflammation using High-Dimensional Biology techniques
- The relationship between inflammation and preterm parturition
- The role of adipocytokines in the development of adverse pregnancy outcomes
- The role of the vascular endothelial growth factor (VEGF) pathway in the pathogenesis of preeclampsia
- The role of infection and inflammation in fetal death
- The molecular basis of fetal growth restriction
- Identification, localization, and function of novel growth hormones in human pregnancy
- Idopathic vaginal bleeding as a clinical manifestation of intra-amniotic infection
Important Points & Discoveries
- Intra-amniotic infection and/or inflammation can lead to the Fetal Inflammatory Response Syndrome (FIRS) and is a major mechanism of disease responsible for numerous perinatal and infant morbidities including, neurologic handicap and cerebral palsy
- Characterization of the role of adipokines in normal pregnancy, preeclampsia, small for gestational age neonates, gestational diabetes, pyelonephritis, and spontaneous preterm labor
- Identification of placental growth hormone in the fetal circulation with novel implications for fetal growth
- The use of both cervical length and fetal fibronectin improves the prediction of preterm delivery in patients with preterm labor and intact membranes
- Failure of physiologic transformation of the spiral arteries in patients with preterm labor and intact membranes
- Mazaki-Tovi S, Romero R, Vaisbuch E, Kusanovic JP, Erez O, Gotsch F, Chaiworapongsa T, Than NG, Kim SK, Nhan-Chang CL, Jodicke C, Pacora P, Yeo L, Dong Z, Yoon BH, Hassan SS, Mittal P. Maternal serum adiponectin multimers in preeclampsia. J Perinat Med 2009;37:349-63.
- Mazaki-Tovi S, Romero R, Kusanovic JP, Vaisbuch E, Erez O, Than NG, Chaiworapongsa T, Nhan-Chang CL, Pacora P, Gotsch F, Yeo L, Kim SK, Edwin SS, Hassan SS, Mittal P. Maternal visfatin concentration in normal pregnancy. J Perinat Med 2009;37:206-17.
- Mittal P, Romero R, Kusanovic JP, Edwin SS, Gotsch F, Mazaki-Tovi S, Espinoza J, Erez O, Nhan-Chang CL, Than NG, Vaisbuch E, Hassan SS. CXCL6 (granulocyte chemotactic protein-2): a novel chemokine involved in the innate immune response of the amniotic cavity. Am J Reprod Immunol 2008 Sep;60:246-57.
- Mittal P, Hassan SS, Espinoza J, Kusanovic JP, Edwin S, Gotsch F, Erez O, Than NG, Mazaki-Tovi S, Romero R. The effect of gestational age and labor on placental growth hormone in amniotic fluid. Growth Horm IGF Res 2008 Apr;18:174-9.
- Mittal P, Espinoza J, Hassan S, Kusanovic JP, Edwin SS, Nien JK, Gotsch F, Than NG, Erez O, Mazaki-Tovi S, Romero R. Placental growth hormone is increased in the maternal and fetal serum of patients with preeclampsia. J Matern Fetal Neonatal Med 2007 Sep;20:651-9.